Certain Drugs Distributed by the National Cancer Institute

Medicare covers NCI-designated Group C drugs when the prescribing physician is registered with NCI (FD-Form 1573), a written request specifying the disease is submitted to NCI, use conforms to NCI guidelines, and all adverse reactions are reported to the Investigational Drug Branch. MACs may presume coverage of the drug and related hospital stay if NCI distribution controls are met and all other Medicare coverage requirements are satisfied; disputed cases must be resolved with the QIO or MAC medical consultants.

"Physician must be registered with the NCI as an investigator by having completed and maintained an FD-Form 1573 to receive Group C drugs."

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