President Bush Unveils FY 2009 Budget Proposal
President Bush released his proposed budget for FY 2009 on February 4. The budget contained flat funding for the National Institutes of Health (NIH) and the National Cancer Institute (NCI) and would reduce Medicare spending by $178 billion over five years. The budget request also provides $224 billion for Medicaid and the State Children’s Health Insurance Program (SCHIP), including $450 million in outreach grants to help enroll uninsured low-income children in the programs.

In its annual report, Nation's Investment in Cancer Research, released earlier this week, NCI stated that for FY 2009, it would need $5.2 billion in funding to simply sustain its current level of activities. In order to accelerate progress, NCI determined it would need approximately $6 billion. The President allocated $4.8 billion for NCI in his budget proposal.

With regards to funding for the current fiscal year, NCI Director John Niederhuber, MD, reported to NCI’s National Cancer Advisory Board members earlier this week that the $4.8 billion appropriation for FY 2008 is essentially flat compared with FY 2007. Dr. Niederhuber said that this flat funding is requiring NCI leaders to initiate 3-percent reductions across each NCI division, office, and center. According to the NCI Cancer Bulletin, this will include reducing: competing research project grants from 1,312 to 1,283; patient accruals for Community Clinical Oncology Program (CCOP) trials; and funding for long-term cancer survivorship research by $1.7 million.

The President's FY 2009 budget request also includes an increase of approximately 6 percent in funding for the Food and Drug Administration (FDA), for a total of $2.4 billion. A significant portion of the increase (60 percent) would come from higher user fees paid by pharmaceutical and device companies. Only about $50 million of the increase would come from Congressionally appropriated funds. FDA stated that about $32 million of the new funding would go toward food safety activities.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or publicpolicy@asco.org.

Senate HELP Committee To Hold Hearing on Workforce Issues
The Senate Committee of Health, Education, Labor, and Pensions (HELP) will hold a hearing, “Addressing Healthcare Workforce Issues for the Future,” on February 12.

The hearing will address workforce shortages in primary care and student loan reimbursement programs. ASCO will submit testimony to the HELP committee, and more information on the specifics of the hearing will be available in the next issue of Cancer Policy Today.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or workforce@asco.org.

ASCO Comments on FDA Science Board report
On February 4, ASCO submitted comments to the FDA on its report, “FDA Science and Mission at Risk,” released in December.

ASCO stated that FDA should increase collaborations with professional societies in order to better address its scientific needs. ASCO has already collaborated with FDA to hold meetings with groups of experts to discuss issues such as clinical trials endpoints and alternative trial designs and also provides educational opportunities for FDA experts through its Annual Meeting, thematic meetings, and workshops.

ASCO also encourages FDA to strengthen its relationships with other federal agencies, such as the NIH, as it is very important in this time of constrained federal funding to leverage all of our scientific resources.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or researchpolicy@asco.org.

Ask Your Senators to Take Action on Genetic Nondiscrimination Bill
The Genetic Information Nondiscrimination Act, or GINA, (S. 358) provides important federal protections against the misuse of genetic information by employers and health insurers. The bill has bipartisan support and has passed the House of Representatives, but GINA has not moved in the Senate. GINA needs to be brought to the Senate floor for a vote. Senate Majority Leader Harry Reid (D-NV) can make this happen, but only if he hears from his constituents and colleagues.

Help make GINA one of Sen. Reid’s priorities by writing or calling your senators and asking them to encourage Sen. Reid to take action on this legislation. A sample letter for you to personalize and send to your senators is available on ASCO's Grassroots Action Center. If you prefer to call your senators, their phone numbers can be found by entering your zip code on the Elected Officials page of the Grassroots Action Center.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or grassroots@asco.org.

ASCO Comments on the HOPPS Interim Final Rule for 2008
On January 28, ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Hospital Outpatient Prospective Payment System (HOPPS) final rule for 2008.

ASCO remains concerned by the practical implications certain final rule decisions (and the interaction of those policy decisions) will have on access to cancer care. ASCO’s comments focus on three main policy topics of concern:

• Reductions in payment for drugs and biologicals in the hospital outpatient setting
  
• Increased packaging of drug and biological therapies
  
• Payment for therapeutic radiopharmaceuticals
  

For more information, contact ASCO's Cancer Policy & Clinical Affairs Department at 703-299-1050 or publicpolicy@asco.org.

ASCO Asks CMS for Clarification on ESA Coverage Decision
On February 4, ASCO sent a letter to CMS Acting Administrator Kerry Weems, asking the Agency to clarify its instructions to carriers on how to implement its National Coverage Decision on ESAs.

ASCO’s primary concern is a statement in carrier instructions declaring that claims for ESA use should always be denied “when a hemoglobin 10 g/dL or greater or hemocrit 30% or greater is reported.” This instruction is not consistent with certain provisions in the coverage decision.
ASCO is asking that the transmittal and related policy guidance issued by CMS be corrected as soon as possible to avoid further confusion.

Watch your Mail for Physician Practice Information Survey
The American Medical Association (AMA) and more than 70 other organizations, including ASCO, are conducting a comprehensive multi-specialty survey of U.S. physician practices. The results will be used to positively influence national decision makers to ensure accurate and fair representation for all physicians and patients and to communicate the challenges of running a practice that provides expert patient care while maintaining sustainability. CMS stated it will use the study results to help determine physician payments. The survey firm, Dmrkynetec, will survey randomly selected physicians and practice managers. Please encourage your staff to participate, as the survey’s success depends on accurate and complete data. All responses will remain confidential.

News and Notes
National Audiocall on Adapting to Changes in Medicare Available Online
ASCO's National Audiocall on Adapting to Changes in Medicare in 2008 was held January 9. The slide presentation and call materials are posted to ASCO's Web site. A taped version of the call also is available; contact Julia Tomkins or Laura Cathro at 703-299-1050 for more information.

Election Period Extended for Competitive Acquisition Program
An additional 2008 Competitive Acquisition Program (CAP) for Drugs and Biologicals physician election period began January 15 and will conclude February 15. Visit the CMS Web site for more information.

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 subscribing to Cancer Policy Today to forward their administrator's contact information to practice@asco.org.