From the CPC Chair
Monitoring the Impact of the 2006 Demonstration Project
As the first month of the Centers for Medicare & Medicaid Services (CMS) 2006 Oncology Demonstration Project comes to a close, ASCO’s team in Washington is closely monitoring and collecting information from practices on the impact of the new program.
ASCO’s website contains a list of Frequently Asked Questions (FAQ), similar to the one developed for the 2005 demonstration project, which will provide practices with answers to questions about the nuances of the 2006 project. ASCO staff will update the FAQs as we receive additional clarifications from CMS.
Please contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050, or publicpolicy@asco.org, to provide information on how the demonstration project is working for your practice. We are collecting this information and will share it with CMS and Members of Congress in an effort to ensure that practices can focus on providing quality care while minimizing administrative issues.
Medicare Part D Update
ASCO would like to thank practices that have provided information on problems they have experienced with Part D implementation. These issues have been forwarded to the Physicians' Regulatory Issues Team at CMS.
In response to physician concerns about the administrative hassle and coverage problems under Part D, CMS has developed additional resources for physicians and their staff. On January 27, CMS published a letter for healthcare professionals outlining the resources available to providers and to communicate CMS’ ongoing efforts to address Part D issues. In coordination with the contracted Part D prescription drug plans (PDPs), CMS compiled two contact information lists for providers to use when performing appeals and exceptions. The contact list contains phone and fax numbers and/or e-mails for almost all contracted PDPs. In addition, CMS has extended the transition coverage period an additional 60 days.
CMS has identified confusion regarding drugs that are covered under Part B but filled by retail pharmacies and has published a reference guide to clarify coverage for Part B versus Part D drugs. CMS also has recommended that prescriptions written by hematologists/oncologists for certain drugs include the diagnosis, the indication, and whether the coverage is Part B or Part D.
Physicians and their staff can find and review PDP formularies using Medicare’s Formulary Finder or by visiting the Epocrates website. Epocrates is a medical software company that has developed downloadable software containing PDP formularies.
CMS holds weekly Part D conference calls open to all physicians and healthcare professionals every Tuesday afternoon at 2:00 PM EST. The calls can be accessed by dialing 1-800-619-2457 and referencing passcode “RBDML.” Providers also can e-mail CMS directly at PRIT@cms.hhs.gov with problems they are experiencing. Please provide plan information when describing specific issues.
President Releases 2007 Budget
This week, President Bush sent his 2007 budget proposal to Congress. According to the budget documents, the President is recommending that funding for the National Institutes of Health stay flat from 2006 to 2007. The National Cancer Institute, however, would receive a cut of $40 million, or 0.8%.
In addition, the President is recommending over $40 billion in cuts to the Medicare program over the next 5 years. The budget does not include any provisions related to reimbursement for cancer care.
The President’s budget – and rhetoric from both Congress and the Administration – signal a tight fiscal environment for the coming year.
JOP Spotlight
The March issue of the Journal of Oncology Practice (JOP) will feature an article written by Susan Molinari, former Member of Congress from New York, highlighting upcoming issues in Congress and ASCO’s strategy to protect and advance quality cancer care while navigating the ever-changing legislative environment in Washington.
The March JOP also will include articles addressing the Institute of Medicine’s adult cancer survivor report, as well as articles on the challenges and benefits of working with hospital employees, and IT solutions for improving cancer care quality.
News and Notes
2006 Legislative Conference: April 26 – 27, 2006 in Washington, D.C.
Registration is now open for ASCO’s 2006 Legislative Conference on Capitol Hill, which will highlight ASCO’s policy initiatives and research agenda. Last year, ASCO members from across the country convened on Capitol Hill to hear from the heads of CMS, FDA and NCI as well as Members of Congress. This year members will again hear directly from Congress and other national leaders responsible for policies that affect oncology.
For more information or to register for the conference, e-mail grassroots@asco.org, or call 703-519-1413.
Oncology Workforce Study
ASCO and the Association of American Medical Colleges (AAMC) are continuing to collect data on oncology workforce needs. The Oncology Workforce Study includes questions on: practice and patient volume, job satisfaction, use of nurse practitioners and physician assistants and views on approaches to assure future access to oncology care. This survey will provide comprehensive data to help guide overall practice planning.
If you have been selected to participate in this survey, it is important that you complete and submit your results. The survey is being administered now, and the results will be reported at the 2006 ASCO Annual Meeting. Please contact Suanna Bruinooge in ASCO's Cancer Research Department at bruinoos@asco.org with any questions.
National Provider Identifier Information
On January 31, CMS posted National Provider Identifier (NPI) information for Medicare Organization Provider Subparts. Subpart designation covers an organization healthcare provider who needs a NPI in order to be identified in HIPAA standard transactions. CMS prepared a document describing the NPI "subpart" concept and its relationship to the way in which Medicare enrolls its organization providers. CMS also has dedicated a web page to all the latest NPI news for healthcare providers. Online CMS resources include:
