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Re-naming and re-gaming: Medicare's doomed attempt to reform reimbursement for injectable drugs.

Hastily crafted provisions in the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, intended to reform the government's flawed method for reimbursing providers who administer injectable drugs, will exacerbate existing economic and clinical problems instead of resolving them. The new provisions recast Medicare's traditional drug reimbursement system; increase temptations for physicians to overuse injectable drugs; and promise to aggravate the economic problems Congress attempted to fix with the new law. Medicare can resolve these problems by reimbursing providers for injectable drugs based on their actual acquisition cost rather than on estimates embedded in a complex drug reimbursement system.