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Current CAP Activity: An additional 2008 CAP physician election period concluded on February 15, 2008. Bidding for 2009-2011 Approved CAP Vendor Contracts closed on February 15, 2008. For more information, please see the "Information for Bidders" page. 2008 CAP drug lists and payment amounts are posted in the downloads section of the Approved CAP Vendor page About the CAP: Section 303 (d) of the Medicare Modernization Act (see Downloads section below) requires the implementation of a competitive acquisition program (CAP) for Medicare Part B drugs and biologicals not paid on a cost or prospective payment system basis. The CAP is an alternative to the ASP (buy and bill) methodology for acquiring certain Part B drugs which are administered incident to a physician's services. Section 108 of the Medicare Improvements and Extension Act under Division B, Title I of the Tax Relief Health Care Act of 2006 (MIEA-TRHCA) amended Section 1847b(a)(3) of the Social Security Act and requires that CAP implement a post payment review process. This procedure is done to assure that payment is made for a drug or biological under this section only if the drug or biological has been administered to a beneficiary. In late 2005, CMS conducted the first round of bidding for approved CAP vendors. The CAP was implemented on July 1, 2006. Links to the following pages appear in the navigation pane near the top left of this page: Information for Physicians- contains physician election updates and links to other resources, including billing tips, for CAP physicians and for physicians who are interested in participating in the CAP Information for Bidders and CAP Bidder - Background contain information about the bidding process for approved CAP vendors Regulations and Notices-describes the CAP's regulatory background Approved CAP Vendor – provides contact information for the approved CAP vendor, appeals information, and links to drugs that are supplied under the CAP Noridian Administrative Services is the CAP designated carrier. Noridian is responsible for vendor enrollment, processing CAP drug claims, answering inquiries, and conducting dispute resolution. A link to Noridian's website appears in the Related Links Outside CMS section below. Noridian Administrative Services, the designated carrier for the Medicare Part B Competitive Acquisition Program (CAP), has created a presentation about CAP for Supplemental Insurance Companies. This presentation includes information on the general background of CAP and how CAP affects claims submissions. The slides are available in the "Downloads" section of this page.
Page Last Modified: 02/28/2008 2:27:49 PM
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