Editor: Joseph S. Bailes, MD, Chair, ASCO Government Relations Council

ASCO Relays Concern to House Speaker Pelosi about Tying Public Plan to Medicare
On October 23, ASCO sent a letter to House Speaker Nancy Pelosi (D-CA) expressing deep concern about a proposal to tie payment rates for health care professionals under the public insurance plan option to Medicare payment rates.

Medicare Payment Fix Does Not Pass in Senate
The Senate did not move forward legislation to repeal the SGR formula, so other legislative options are currently being considered.

House Drafts Continuing Resolution to Fund Federal Government Past October
The House Appropriations Committee is drafting a continuing resolution to fund the federal government at FY 2009 levels past the end of October. The current CR expires October 31.

ASCO Preparing to Develop Two New Provisional Clinical Opinions
ASCO is in the process of developing two new Provisional Clinical Options, to address the use of EGFR mutation testing in patients with advanced NSCLC, and recommendations for Hepatitis B screening for patients slated to receive cytotoxic therapy.

NCI Issuing Funding Opportunity for Community Cancer Center Program Sites
NCI has posted a Request for Proposals for new NCI Community Cancer Center Program (NCCCP) sites.

Leukemia and Lymphoma Society and Avalere Health Launch Survey on Multiple Myeloma Access Issues
Leukemia and Lymphoma Society (LLS) and Avalere Health are launching the first-ever survey of the barriers myeloma patients face when trying to receive care.

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ASCO Relays Concern to House Speaker Pelosi about Tying Public Plan to Medicare
On October 23, ASCO sent a  letter to House Speaker Nancy Pelosi (D-CA) expressing deep concern about a health care reform proposal to tie payment rates for health care professionals under the public insurance plan option to Medicare payment rates.

Many oncologists would be unable to participate in a plan that mirrors the Medicare system, the letter states, because current Medicare rates for cancer services – particularly for administration of chemotherapy regimens – are both inadequate and unstable. ASCO highlights in the letter the fact that the current Medicare reimbursement rates do not cover the costs of treating Medicare beneficiaries with cancer and have already caused many practices across the country to close. Extending the current Medicare platform to millions of additional patients will further jeopardize this already-strained system.

ASCO urges Rep. Pelosi to ensure that any public health insurance option allow for voluntary participation by providers and permit individual providers to directly negotiate fair payment levels.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or email publicpolicy@asco.org.

Medicare Payment Fix Does Not Pass in Senate
By a vote of 47-53, last week the Senate failed to move forward legislation to repeal the sustainable growth rate (SGR) formula. Senate Majority Leader Harry Reid (D-NV) has indicated that he is committed to preventing the 21 percent cut in physician payments from being implemented in 2010. The Senate is considering language, which may be attached to their version of health care reform legislation that moves forward, to provide a temporary fix to the SGR formula.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or email publicpolicy@asco.org.

House Drafts Continuing Resolution to Fund Federal Government Past October
The House Appropriations Committee is drafting a continuing resolution, or “CR,” to keep much of the federal government running at FY 2009 levels past the end of October. The current CR expires October 31. Congress has passed 4 of the 12 annual spending bills, but has not yet passed legislation to fund the National Institutes of Health (NIH) and the National Cancer Institute (NCI). Congress is expected to pass and the President is expected to sign the CR.

For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or email publicpolicy@asco.org.

ASCO Preparing to Develop Two New Provisional Clinical Opinions
ASCO is in the process of developing two new Provisional Clinical Opinions (PCO) one, to address the use of EGFR mutation testing in patients with advanced NSCLC, and another addressing recommendations for Hepatitis B screening for patients slated to receive cytotoxic therapy.

ASCO develops its PCOs to offer timely clinical direction to the ASCO membership in response to new information, such as the publication of a new guideline, or in response to the publication or presentation of potentially practice-changing data from major studies or other controversial topics. A PCO may serve in some cases as interim direction to the membership pending the development or updating of an ASCO clinical practice guideline.

ASCO is drafting a PCO to address use of EGFR mutation testing in patients with advanced NSCLC in response to a study published in September in the New England Journal of Medicine, which found prolonged progression-free survival for patients with EGFR mutations who took gefitinib, and shorter progression-free survival for patients with wild-type EGFR treated with gefitinib, spurring debate over EGFR mutation testing.

ASCO is addressing Hepatitis B screening in a PCO in response to the Centers for Disease Control and Prevention (CDC) issuance of “Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection,” which represents a potentially major change in practice.

ASCO plans to complete drafts of each PCO before the end of the year. For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or guidelines@asco.org.

NCI Issuing Funding Opportunity for Community Cancer Center Program Sites
The National Cancer Institute (NCI) has posted a Request for Proposals (RFP) for new NCI Community Cancer Center Program (NCCCP) sites.

The NCCCP pilot program has formed a national network of community cancer centers to expand cancer research and deliver advanced care to patients in the community setting. Started in 2007, the NCCCP includes 16 community hospitals located primarily in underserved rural, small-town, and urban areas in 14 states. The NCCCP goals are to: 1) reduce cancer health care disparities; 2) recruit more patients to clinical trials; 3) standardize collection of tissue and other biospecimens for research; 4) improve information technology capabilities, including instituting electronic health records; 5) improve quality of care; and 6) enhance cancer survivorship and palliative care.

Using funds from the American Recovery and Reinvestment Act, NCI plans to add around 14 more NCCCP sites, to explore how NCI-designated cancer centers can partner with hospital-based community cancer centers using the NCCCP model. NCI is allocating funds to current NCCCP hospitals for two years for 18 specific projects encompassing clinical trials, disparities, community outreach, biospecimen collection, electronic health records, quality of care, partnerships with state cancer plans, communications, survivorship and palliative care.

For more information, access NCI’s RFP.

Leukemia and Lymphoma Society and Avalere Health Launch Survey on Multiple Myeloma Access Issues
Anecdotal evidence from multiple myeloma patients and their oncologists suggests that many patients face challenges accessing care, but little has been done to quantify these access issues. To address this, the Leukemia and Lymphoma Society (LLS) and Avalere Health are launching the first-ever survey of the barriers myeloma patients face when trying to receive care, including:

• Problems finding an oncologist who is knowledgeable about myeloma.
  
• Issues related to transportation to and from appointments.
  
• Concerns with the cost of treatment and insurance coverage.
  

The result of the survey will form the basis for a public policy proposal to address the specific needs of myeloma patients. LLS and Avalere are asking providers to encourage myeloma patients to participate in this groundbreaking study. If you know of patients interested in participating in the survey, please ask them to visit: http://lls.avalerehealth.net/MM/

All responses will remain anonymous and confidential. LLS and Avalere will share the survey results with participants. For more information, contact the LLS Information Resource Center at 800-955-4572, or find information online at www.LLS.org.

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News and Notes
Participate in QOPI and the QOPI Certification Program
ASCO’s QOPI® Certification Program will certify oncology practices that achieve rigorous, oncologist-defined standards for high-quality cancer care. Details about the Certification Program, including a participation guide and introductory presentation, are now available online. Visit http://qopi.asco.org/certification or email qopicertification@asco.org for more information.

Practical Tips for the Oncology Practice Available
Practical Tips for the Oncology Practice, 5th Edition is the premier resource for oncology practices. This publication provides guidelines on coding, billing and coverage of oncology-related services and outlines the laws and regulations that affect an oncology practice. Practical Tips contains explanations of many Medicare initiatives and provides excerpts from Medicare manuals. This resource is a must-have for oncology practices. Order yours today by visiting www.asco.org/practicaltips or by calling ASCO’s Customer Service hotline at 888-273-3508.

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 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.