Message from the CPC Chair
This past weekend, ASCO hosted its second annual State Affiliate Leadership Conference in Arlington, Virginia. This two-day meeting, attended by leaders from 36 of ASCO’s affiliated state organizations, featured speakers who discussed a variety of facets associated with running their organizations.

Topics addressed at the conference included:

• Ensuring that affiliates are compliant with legal, financial, and educational requirements.
• Communicating with and determining the priorities of affiliate membership.
• Lobbying state legislatures.
• Developing and implementing strategic plans.
• Securing financial support in order to provide programs and services to affiliate membership.

In addition, many state affiliates shared their achievements from the past year, including a number of successful educational meetings, website development, and advocacy efforts.

A great deal of ASCO’s strength comes from the commitment of its members treating patients in communities large and small across the United States and around the world. ASCO is pleased to see the state affiliates growing in strength and number, and we are interested in providing additional tools where needed.


Office of Inspector General Releases Report on Drug Pricing
The HHS Office of Inspector General has released the results of its survey of the prices that oncologists and hematologists pay for drugs, compared to the Medicare reimbursement amounts. The report presents the survey results in a manner suggesting that the new payment system is working well, stating, "Physician practices…could generally purchase drugs…at less than the MMA-established reimbursement rates."

However, the OIG data show that for virtually every drug, many physicians paid more than the Medicare reimbursement amount. OIG’s conclusion that physicians could "generally" purchase drugs for less than the Medicare reimbursement rate ignores that fact that large numbers of physicians could not.

Indeed, of the 39 drugs surveyed by the OIG, only three could be purchased by all physicians for less than the Medicare reimbursement amount. More than 20% of physicians could not obtain 17 of the 39 drugs without taking an out-of-pocket loss.

ASCO has long advocated that the Medicare payment for drugs allow all physicians, regardless of practice size, to purchase the chemotherapy drugs their patients need.



ASCO and Others Urge Congressional Leadership To Stop Cuts in Medicare Physician Payments
On October 3, ASCO and more than 100 state and national medical societies sent letters to Senate Majority Leader Bill Frist and Speaker of the House Dennis Hastert, urging them to prevent the scheduled 4.4% cut to Medicare payments currently scheduled to go into effect on January 1, 2006, as a result of the sustainable growth rate (SGR) formula.

According to an American Medical Association survey, these projected cuts would result in the closure of facilities and a substantial reduction in the number of new Medicare patients accepted by physicians.


ASCO Submits Comments to CMS on Physician Fee Schedule
ASCO has submitted comments on CMS’s Physician Fee Schedule for 2006, including strong concerns about four key elements of the proposed fee schedule: the methodology for determining practice expense relative values, revisions to the methodology for direct costs, reduction of payments for multiple imaging procedures, and the demonstration project on chemotherapy services. The following are some key comments provided:

Practice Expense Relative Values
ASCO has two concerns with CMS’s proposal to institute a “bottom up” approach to determining the relative values for practice expenses. First, the lack of specific details as to how the proposed change will affect drug administration services does not provide ASCO an opportunity to effectively comment on the changes. Second, ASCO has requested that the methodology for dealing with indirect costs should be revised at the same time as the revision for direct costs.

Payment Reduction for Multiple Diagnostic Imaging Procedures
ASCO’s main concern is that an arbitrary 50% reduction in payment for multiple imaging procedures does not take into account the true clinical staff activities and supplies. ASCO recommends that CMS conduct a study to determine how much work and additional supplies are actually avoided when multiple procedures are performed, instead of issuing an across-the-board cut of 50%.

Chemotherapy-Related Demonstration Project
ASCO continues to applaud CMS for developing the current oncology demonstration project. However, this project is set to expire in 2006. While the project is out of the framework for the physician fee schedule, ASCO has taken this opportunity to again underscore to CMS that the demonstration project is crucial to providing access to quality cancer care for America’s seniors, and that an extension is necessary to protect this access in years to come.


News and Notes

Congressional Leaders Support Extending the Oncology Demonstration Project
As recently reported, on October 6, Congress passed by voice vote House Resolution 261, urging the Centers for Medicare & Medicaid Services to extend the oncology demonstration project through 2006.

During the floor statements, Resolution sponsor Rep. Ralph Hall (R-TX), along with Reps. Nathan Deal (R-GA), Sherrod Brown (D-OH), and Nancy Johnson (R-CT), lauded the demonstration project as helping to preserve patient access to cancer care. Rep. Hall specifically thanked ASCO and its members for our efforts in support of the Resolution. To watch a clip of these floor statements, please visit ASCO.org.

If you have any questions, call ASCO's Cancer Policy & Clinical Affairs Department at 703-299-1050, or email publicpolicy@asco.org.