Medicare Compliance & Reimbursement

The movement to import less-expensive, Food and Drug Administration-approved medications from Canada has gone way beyond the old-style bus trip across the border.

Mayors and governors - including the Republican governor of Minnesota - have moved to systematically facilitate the import of Canadian drugs for their Medicaid and public employee pension programs, and even for their entire populations.

At times the pressure to allow such imports - or "reimports," since most of the drugs involved are manufactured in the United States - has seemed unstoppable, but the message from the Medicare conferees is, "Not so fast." The final bill will allow the import of Canadian drugs only if the Secretary of Health and Human Services certified that it would pose no additional danger to Americans - the very certification required by current law, which HHS Secretary Tommy Thompson - along with his Clinton administration predecessor - has refused to provide.

The Bush administration is moving aggressively in other ways against Canadian imports. It recently succeeded in getting a federal judge in Oklahoma to issue a preliminary injunction at least temporarily shutting down Rx Depot, a Web site that helps American consumers to import drugs from across the border by linking them with Canadian pharmacies. However, FDA Commissioner Mark McClellan was largely rebuffed in his attempt, during a recent visit to Canada, to get that country's authorities to crack down on drug exports to the United States.