Less than a month, after the US Senate passed a resolution requesting the Centers for Medicare and Medicaid Services reconsider its decision to place tougher reimbursement restrictions on anemia drugs used by chemo patients, two congressional reps have introduced a bill to overturn the CMS move, The Hill reports. Anna Eshoo, a California Democrat, and Mike Rogers, a Michigan Republican, introduced legislation that maintains the CMS revised payment policy puts patients at risk by restricting Medicare coverage of EPO drugs - Amgen’s Aranesp and Epogen, and Johnson & Johnson’s Procrit.

Medicare proposed the new guidelines after the FDA added warnings to the drug labels in March over concerns that usage at high levels can increase risk of blood clots, heart attack and death. An FDA panel in May also called for restrictions. Cancer docs, however, have argued that higher levels are necessary to stabilize many patients.

As a result, the drugmakers say their finances will take huge hits. Amgen and J&J are both laying off employees, citing the Medicare decision as one reason. Amgen is also shelving plans to build a plant in Ireland. And so the drugmakers began lobbying Washington in earnest this year. They’re getting help, by the way, from the American Society for Clinical Oncology, the American Society of Hematology and US Oncology, a treatment center company.

The lawmakers stepped in after the drug makers and their allies in the cancer-care provider community failed to convince CMS to reconsider its July decision. Eshoo and Rogers, along with 222 colleagues, wrote CMS shortly after the agency announced its new policy, questioning the rationale behind the agency’s decision and suggesting it would hurt cancer patients. Last week, Edolphus Towns, a New York Democrat, wrote the agency demanding documentation to justify the new policy.

The Eshoo-Rogers legislation takes the form of a Congressional Review Act joint resolution, a rarely used tool that allows Congress to overturn regulatory decisions made by federal agencies. The resolution may never come to a vote, but its introduction serves as a strong reminder to CMS that the special interests with a stake in Medicare coverage of EPO have friends in Congress.

Although the new CMS policy affects the use of the drugs only for cancer patients, not dialysis patients, the drug, dialysis and cancer-center industries - not to mention their investors - have been closely watching for signs that Medicare’s appetite for EPO drugs could be waning. CMS’s decisions on which drugs or medical devices to cover also tend to serve as the template for what private insurance companies will pay for.

In addition, Congress has been intensifying its scrutiny of Medicare spending on EPO, which represents the single largest drug expense for the program. In 2005, Medicare spent $2 billion on EPO drugs to treat anemia in patients with end-stage renal disease undergoing kidney dialysis, and nearly another $1 billion to treat cancer patients suffering from anemia resulting from chemotherapy.

Because EPO is administered in doctors’ offices or dialysis facilities, CMS pays the providers for the drug under Medicare Part B, not through the Medicare Part D prescription-drug benefit, which covers medicines taken by patients at home.

Some key lawmakers view the EPO manufacturers skeptically, however, citing Medicare’s rising spending on the drugs. Pete Stark, a California Democrat and chairman of the Ways and Means Health Subcommittee, has been particularly critical of Medicare spending on EPO. He’s argued that Medicare payments for EPO for dialysis patients encourage providers to overuse the drug, driving up costs and endangering patients.

Last week, Stark issued a statement noting that Medicare pays $9.10 per 100 units of Amgen’s Epogen, compared to the $8.03 paid by the Department of Veterans Affairs. According to Stark, Medicare would save $187 million annually if it purchased Epogen at the VA rate.

“Because Medicare pays significantly more for Epogen than do either the Veterans Administration or large dialysis chains, its payment policies create an incentive for over-prescription,” Stark said.