Senate Passes Medicare Legislation
As reported yesterday evening, on July 9 the Senate passed H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008, which would avert the 10.6% cut to Medicare physician payments, by a veto-proof majority vote of 69 to 30.

The legislation would maintain the current 0.5% increase to physician payments from 2007for the remainder of 2008 (retroactive to July 1). The legislation also provides a 1.1% increase for 2009. The House of Representative passed H.R. 6331 before the July 4 recess, also by a veto-proof majority.

On June 26, the bill had failed in the Senate by one vote. However, once Sen. Ted Kennedy (D-MA), who is currently undergoing treatment for brain cancer, traveled to Washington D.C., to cast the 60th vote, nine additional Senators changed their vote in support of the bill. If the bill hadn’t passed, Congress’ next step could have been to freeze physician payment levels for six to eight months, until the legislation could be taken up by the new Congress in 2009.

As agreed upon by the majority and minority leadership, no amendments were included in the legislation. ASCO will continue to work in Congress to pass legislation to exclude the prompt pay discount from the ASP calculation.

ASCO will keep you updated as this legislation advances to the President. The President has threatened to veto the bill, which would force the House and Senate to vote to override the veto.

Thank you to all of you who contacted your Members of Congress to urge them to vote for the Medicare legislation.

Your outreach made a difference. For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at publicpolicy@asco.org.

Proposed 2009 Medicare Physician Fee Schedule Summary
The Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the 2009 Medicare Physician Fee Schedule.

The rule appeared in the July 7, 2008 Federal Register. ASCO has prepared a summary of the proposed rule that highlights the provisions of greatest interest to oncologists. ASCO will be submitting comments to CMS on this proposed rule.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department, at practice@asco.org.

CMS Answers Questions about 10 Day Medicare Physician Payment Hold
On July 2, CMS provided clarification on its recent decision to hold claims under the Medicare physician fee schedule. For claims with a July date of service, CMS is holding claims for 10 days in anticipation that the Congress will pass legislation to avert a 10.6% cut in physician payments that was slated to begin July 1.

The following three Questions and Answers were provided by CMS: Question 1:

• Will claims containing services paid under the fee schedule that contain both June and July dates of service be held?
  
• Yes, your local contractor will hold the entire claim for 10 business days.

Question 2:

• Will claims that contain both services paid under the fee schedule and services paid under a separate fee schedule be held?
  
• Yes, claims that contain both services paid and not paid under the fee schedule will be held. For example, a claim with a July date containing an Evaluation and Management code and a drug code would be held.

Question 3:

• Do the claims held for payment under the fee schedule also include anesthesia and purchased diagnostic services?
  
• 2008, and after that contain services paid under the fee schedule, including anesthesia and purchased diagnostic services.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department, at practice@asco.org.

Wall Street Journal Reports on Rising Costs of Cancer Treatments
On July 8, the Wall Street Journal ran a front-page article on the rising costs of cancer drugs and the effect on practicing oncologists.

The article outlines the issues faced by many community oncologists who are treating patients with expensive drug regimens. The financial impact on the patient who is faced with 20% co-pays for drugs that cost upwards of tens of thousands of dollars is clear. The article reports how these financial impacts are also taking a heavy toll on doctors, leading in many cases to a heavy debt load for practices and threatening to interfere with patient treatment options. The article reporter that often times oncologists who purchase drugs must wait several weeks or longer for reimbursement from insurance companies, putting their practice and ability to care for patients at risk.

The article also cites a study published in the Journal of Clinical Oncology last year, which found that less than half of oncologists regularly raised the issue of cost when discussing treatment options with patients, and cost influenced treatment decisions for 23% of doctors.

The article reported on action that ASCO is taking, through its Cost of Care Task Force, to develop guidance to help doctors discuss cost of care issues with patients. It is crucial that patients have all the information available to them about their treatment options.

For more information on the Cost of Care Task Force, contact ASCO’s Cancer Policy & Clinical Affairs Department, at publicpolicy@asco.org.

Ohio Passes Law Requiring Coverage for People on Clinical Trials
The Governor of Ohio enacted a law requiring insurers to cover routine patient care administered during any stage of an eligible cancer clinical trial. The law will go into effect August 5 and will affect all plans starting October 4.

The law applies to participants in trials approved by the National Institutes of Health (NIH), Food & Drug Administration (FDA), Department of Veterans Affairs, or Department of Defense. A complete list of the states and details on the coverage requirements/agreements is available on the National Cancer Institute’s Web site.

Contact ASCO’s Cancer Policy and Clinical Affairs Department at researchpolicy@asco.org with any questions or for additional information about state clinical trials coverage laws or pending legislation.

Cancer Leadership Council Endorses Access to Cancer Clinical Trials Act
On June 25, the Cancer Leadership Council, of which ASCO is a member, sent a letter to Congress urging members to support the Access to Cancer Clinical Trials Act (H.R. 2676/S. 2999).

The legislation would prohibit health plans from denying covered cancer patients the opportunity to participate in clinical trials.

The letter states that removing economic barriers to clinical trials participation is necessary to ensure that accrual to trials is not slowed and with it the pace of research on new therapies.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department, at publicpolicy@asco.org.

Cancer Leadership Council Voices Concerns on Delayed FDA Expanded Access Rules
On June 25, the Cancer Leadership Council sent a letter to FDA Commissioner Andrew von Eschenbach, MD, expressing concern over the Agency’s delay in issuing a final rule on expanded access programs.

The proposed rule was first published in December 2006, and the public comment period closed in March 2007.

ASCO and the National Coalition for Cancer Survivorship (NCCS) recently sent a letter urging the same action. ASCO and NCCS also filed a citizens’ petition in early 2007, calling on FDA to strengthen expanded access programs to provide people with cancer access to investigational treatment options while preserving the research system so vital to the delivery of more effective therapies.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department, at researchpolicy@asco.org.

Your Participation Needed for the Physician Practice Information Survey
We have reported previously that the American Medical Association (AMA) and more than 70 other organizations are conducting a comprehensive multi-specialty survey of America’s physician practices.

The survey is coming to a close soon, and ASCO would encourage those contacted by Dmrkynetec to participate. If you are selected and have any questions, call Dmrkynetec toll-free at 1-877-816-8940 and ask to speak with an executive interviewer about the 2008 Physician Information and Practice Expense Survey.

ASCO Conducting Learning Needs Assessment of Member Physicians
ASCO is conducting a Needs Assessment of community practice members, focusing on learning styles, barriers to learning, access to technology, and other educational topics. This information will help ASCO more closely tailor products and meetings to members’ individual needs. You may be invited to join a focus group or to simply answer a few questions about your specific educational needs and how ASCO can help.

News and Notes
ASCO Moves into New Office
On July 14, ASCO headquarters will officially relocate to 2318 Mill Road, Suite 800, Alexandria, VA 22314. All staff phone numbers will change as well. The new main number will be 571-483-1300.

New Off-label Compendium
On July 2, 2008, CMS announced that it would recognize Elsevier Gold Standard’s Clinical Pharmacology as a compendium to recognize off-label uses in cancer treatment. This is the third update CMS has made to the listing of accepted compendia. To obtain more information regarding CMS’ recent decision, visit the CMS Web site.

ASCO Coding & Reimbursement Hotline
As of Monday, July 14, there will be a new number for the ASCO Coding & Reimbursement Hotline. Members and their staff can call 571-483-1790 to get answers to coding, coverage, and reimbursement questions.

Join ASCO's Advocacy Network
Advocacy is most effective when Members of Congress and government agencies hear from you, their constituents. By participating in ASCO's Advocacy Network, you will have the opportunity to develop ongoing relationships with your legislators while helping ASCO raise awareness on important cancer issues. To join the Advocacy Network, visit ASCO's Grassroots Action Center.

ASCO Extends Resources to Practice Administrators
ASCO encourages members whose practice administrators are interested in receiving Cancer Policy Today to forward their administrator's contact information to practice@asco.org.