As many of you know, the Centers for Medicare & Medicaid Services (CMS) plans to release its 2006 fee schedule in the next day or so. While CMS has not yet released any details on the fee schedule, preliminary press reports indicate that the oncology demonstration project will be extended in 2006. Of concern is a report that CMS may be earmarking less money for the 2006 demonstration than the $300 million it budgeted in 2005.

Though CMS has not publicized the specifics of the 2006 demonstration project, reports indicate that it will be focused around adherence to clinical guidelines for quality care instead of the current assessment of side effects. CMS has long signaled a preference for supporting "pay-for-performance" initiatives, and the demonstration project would be a step in that direction.

We are disappointed and concerned that funding for the demonstration project will most likely decrease in 2006. However, the extension of the demonstration project at any level is a result of all of your efforts throughout the year, particularly when many leaders in Washington thought the demonstration project should expire.

ASCO’s work with Congress, through our partnership with Rep. Ralph Hall (R-Texas) and others to pass H Res 261, encouraging CMS to extend the demonstration project, shows the extent to which ASCO members have influenced Congress and CMS. When oncologists unite under ASCO, we truly serve as effective advocates for quality care for our patients.

It also is worth noting that the extension of the demonstration project is a significant achievement in light of the undeniable reality of the current budget environment. Unfortunately, the continued costs of war in Iraq and rebuilding the Gulf Coast after the devastation left behind by Hurricanes Katrina and Rita have diverted many federal resources, leading to the need for budget reductions on Capitol Hill and in the Administration.

In listening to ASCO members by extending the demonstration project, CMS has recognized the importance of its role in assessing quality cancer care for America’s seniors. Unfortunately, if the reports we have heard are accurate, CMS may not have gone far enough. Thus, ASCO members, along with all of our partners in the cancer community, will continue to work vigorously with Congress and CMS through 2006 and as long as it takes to protect cancer care for all Americans.

We will provide you with updated and accurate information, as well as a thorough analysis, once the fee schedule is released.