HRSA COVID-19 Uninsured Program will Reimburse Monoclonal Antibody Treatments based on Medicare Rates
Following recent announcements from HHS and CMS regarding distribution of and reimbursement for the COVID-19 antibody therapeutic bamlanivimab, HRSA updated its COVID-19 Uninsured Program FAQs, indicating that it will cover the drug in the same manner as Medicare. Providers may bill the HRSA COVID-19 Uninsured Program for infusion of bamlanivimab, for which Medicare set an initial rate of $309.60 (subject to geographic adjustments). Currently, healthcare providers receive allocations of the drug free, as determined by federal and state health officials (see below for more information). In the future, when healthcare providers begin to purchase monoclonal antibody products, CMS plans to set payment rates in a similar fashion to the rates for COVID-19 vaccines, such as based on 95% of the average wholesale price.