2008 Changes to Medicare Physician Payment Rates
At the end of 2007, Congress passed a Medicare bill that averts the scheduled 10.1% cut to physician payments by replacing it with a 0.5% increase in Medicare payments for first six months of 2008. However, unless Congress acts before July, the 10.1% cut will go into effect at that time.
Since the 2008 Medicare Physician Fee Schedule rates have changed, the Centers for Medicare & Medicaid Services (CMS) is extending the Participation Decision Period an additional 45 days. It will now run through February 15, instead of ending December 31, 2007. All participating status changes were effective as of January 1, 2008.
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or practice@asco.org.
CMS Delays Date of Anti-Markup Provisions in Physician Fee Schedule
On December 28, CMS issued a final rule delaying until January 1, 2009, the date of applicability of the anti-markup provisions described in the 2008 Medicare Final Physician Fee Schedule. The new rule would apply when a physician bills for a purchased diagnostic test or bills for a diagnostic test for which the professional or technical component was performed at a site other than the physician’s office. If the test was purchased, the Medicare payment to the physician (including coinsurance and deductible) could not exceed the net charge that the physician paid for it. If either the technical component or the professional component was furnished outside the physician’s office, then the anti-markup provision would apply to that component.
In response to concerns from ASCO, the AMA, and other medical specialty societies, CMS has postponed implementation of the rule until January 1, 2009 with the exception of its applicability to “anatomic pathology diagnostic testing services furnished in space that: (1) is utilized by a physician group practice as a ‘centralized building’”…and “(2) does not qualify as a ‘same building’” under the regulations. Also exempted from the delay is the provision that prohibits mark-up of the technical component of purchased diagnostic tests.
The rule that implements the delay was published in the Federal Register January 3.
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or practice@asco.org.
ASCO Submits Comments to FDA on Advisory Committee Members’ Conflict of Interest and Voting
ASCO sent the Food & Drug Administration (FDA) comments in response to its issuance of two draft guidance documents on the public availability of advisory committee member conflict of interest (COI) disclosures and waivers, and advisory committee voting procedures.
ASCO believes the decision to make voting simultaneous rather than sequential is an improvement that will ensure that every committee member’s vote is significant. ASCO also encouraged the agency to charge committee members to interact with each other, so that they may take advantage of one another’s expertise.
ASCO also supports the enhanced transparency that will occur when waivers and the financial interests associated with waivers are disclosed publicly. However, ASCO is still concerned about the draft March 2007 guidance for determining COI and eligibility for participation in advisory committee meetings. The draft guidance lacks balance between appropriately managing COI and having the necessary expertise on FDA’s advisory committees.
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or researchpolicy@asco.org.
ASCO Issues Comments on Oversight of Genetic Testing
ASCO submitted comments in response to the National Institutes of Health (NIH) Secretary’s Advisory Committee on Genetics, Health and Society (SACGHS) draft report on the U.S. system of oversight of genetic testing.
ASCO commended SACGHS’ special attention to the analytical and clinical validity of genetic tests; however, it noted several areas in which the report does not go far enough in ensuring test validity. Specifically, ASCO’s commented on the following issues:
- CMS Regulation of Laboratories
- FDA Regulation of Genetic Tests
- Ensuring Appropriate Use of Genetic Tests
- Voluntary Listing of Genetic Tests
- Clinical Decision Support
- Direct to Consumer Advertising
Visit ASCO’s Web site to view the society’s policy statement on genetic testing. For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or cancerpolicy@asco.org.
ASCO Web Site Updates PQRI Resources
ASCO has updated its PQRI Web site, www.asco.org/pqri, to include relevant links and a table of oncology-related measures. The table, 2008 PQRI Measures for Consideration by Oncology Providers, which includes links to AMA-developed worksheets, may be especially helpful in guiding practices' decision making regarding participation and measure reporting. PQRI also will be a topic reviewed on today’s National Audiocall on Adapting to Changes in Medicare for 2008.
As the 2008 PQRI program launched January 1, practices choosing to participate must select measures and initiate claims-based reporting as soon as possible. As in 2007, successful participation in PQRI will result in a bonus payment of up to 1.5% of total allowed charges for covered Medicare physician fee schedule services.
Oncologists should note that the codes and specifications for 2008 PQRI measures 71 (Hormonal therapy for stage IC-III, ER/PR positive breast cancer), 72 (Chemotherapy for stage III colon cancer) and 73 (Plan for chemotherapy documented before administration) have changed and the 2007 codes for those measures can no longer be reported. Complete details can be found on ASCO's PQRI Web site.
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or practice@asco.org.
News and Notes
Election Period Extended for Competitive Acquisition Program
An additional 2008 Competitive Acquisition Program (CAP) for Drugs and Biologicals physician election period will begin January 15 and will conclude February 15. Visit the CMS Web site for more information.
Guideline Alerts Now Available on ASCO Web site
ASCO has improved its Web capabilities with the addition of a new Journal of Clinical Oncology (JCO) alert specifically for clinical practice guideline news. To sign up, visit ASCO’s Web site.
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 Website Adds URL to Access Information on EHRs
Information regarding electronic health records (EHR) is now available at www.asco.org/ehr.
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.
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