February 18: CMS Asking ASCO for Input on "Underwater" Drugs

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February 18: CMS Asking ASCO for Input on "Underwater" Drugs

Letter from the CPC Chair
CMS Looking for Information on Underwater Drugs
Recently, CMS contacted ASCO, seeking information from ASCO’s membership on “underwater” drugs – drugs for which the cost to your practice is more than the Medicare payment rate. As a result, ASCO is urging members again to complete the drug survey that we sent to you earlier this year.

We know that practices are extremely busy right now, but survey data will provide the best evidence about the impact of the new drug pricing structure.If we provide information to CMS on drug pricing problems, then CMS may take steps to address them.

The drug pricing data that ASCO provided to CMS last fall were critical in alerting CMS that the potential impact of the MMA was greater than estimated.Based in part on this information, CMS established the Quality Demonstration Project to reimburse practices for collecting data on chemotherapy side effects.

ASCO can help you complete the survey, so it will take as little of your time as possible.Please call ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050, or e-mail publicpolicy@asco.org, and an ASCO staff member will help you. As always, any information that you provide will be kept confidential.

Carriers and Reimbursement Issues
ASCO is continuing to monitor and help resolve problems related to Medicare claims processing.In recent weeks, numerous practices have brought specific problems to our attention, and we have worked closely with the Medicare carriers and CMS to resolve them.

Please continue to alert us to issues your practice is having with their carriers so we can reach timely resolutions.Email specific details to us at publicpolicy@asco.org.

News and Notes
Earlier this week, ASCO President David H. Johnson, MD, along with Ellen Stovall, President and CEO of the National Coalition for Cancer Survivorship (NCCS), spoke to 11 consumer and trade health policy reporters at a Media Briefing sponsored by ASCO and NCCS addressing the policy priorities of the cancer community.Dr. Johnson and Ms. Stovall discussed the MMA and its effects on cancer care. Dr. Johnson noted that oncology practices are still determining the full effect of the cuts on their ability to provide care to cancer patients.