Help to make sure the contractors for Medicare payments and physicians have the latest information on what will be compensated, which changes almost daily.  The burden for payment is on the contractor to check for FDA approval, and then further to see if there is any scientific evidence that supports using a drug to treat a disease in case the FDA approval does not include any of this information, so in other words, payment could be possible if clinical studies go beyond what has been recommended by the FDA. Sounds confusing by all means and in the end who really knows what could be compensated at any given time when it comes to drugs for cancer.  BD 

A compendium is a comprehensive listing of FDA-approved drugs and biologics. In some cases, compendia specialize in a particular subset of drugs, such as those used for anti-cancer treatment. Compendia include a summary of how each drug works in the body, as well as information for health care practitioners about proper dosing and whether the drug is recommended or endorsed for use in treating a specific disease. The Medicare local contractors, who process and pay Medicare claims and approve coverage for drugs under Medicare Part B, use compendia as one of several tools to determine whether an anti-cancer drug should be covered under Medicare Part B.

Medicare Updates Its List Of Recognized Sources To Help Make Coverage Decisions For Anti-Cancer Chemotherapy Drugs

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