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Members' Forum


­­­­Welcome to our members' forum, a repository of news about initiatives and activities impacting our region.  The information below is divided into four sections, ANNOUNCEMENTS, PUBLIC COMMENT REQUESTED, UPCOMING OPPORTUNITIES, and RESOURCES. If you'd like information about your initiative or activity posted, check out the News Release Criteria.  

 


ANNOUNCEMENTS


NNECOS Featured on ASCO News & Forum's Spotlight on State Affiliates

We are delighted to announce that the Northern New England Clinical Oncology Society is the featured society on ASCO's online exclusive Spotlight on State Afffiliates. NNECOS is honored to be chosen for this feature and proud to continue to represent all of you as the voice of oncology in Northern New England! http://www.asconews.org/anf/Features/Spotlight+On+State+Affiliates/Northern+New+England+Oncology+Society

1/22/10

ASCO's Quality Oncology Practice Initiative (QOPI®) is designed to promote excellence in cancer care by helping oncologists create a culture of self-examination and improvement. ASCO is now offering the QOPI Certification Program to recognize QOPI participants who achieve rigorous standards for cancer care. The QOPI Certification designation can be used by certified practices to demonstrate an advanced commitment to quality. For more information or to register, go to qopi.asco.org.

  2/5/10

 


 American Society of Clinical Oncology (ASCO) Statement on Cuts to Cancer Care in 2010 Medicare Physician Fee Schedule

See ASCO's Fee Schedule Fact Sheet

FOR IMMEDIATE RELEASE:
October 30, 2009

CONTACT: Jenny Heumann
202-997-1349 (cell)
jenny.heumann@asco.org

Dan Sweet
571-483-1355
dan.sweet@asco.org

Below is a statement for attribution to ASCO CEO Allen S. Lichter, MD:

“Today, CMS issued its physician fee schedule for 2010. The schedule included a one percent cut to oncology services in 2010, part of an overall six percent reduction in reimbursement for cancer care over the next four years. We are deeply concerned that these cuts will continue to erode access to cancer care in the United States.

“The cumulative effect of previous cuts has already caused oncologists to close practices, consolidate locations, and turn away Medicare patients. Further reductions will jeopardize access to care for more people with cancer across the country. Oncology cannot sustain additional cuts at a time when the number of people with cancer is increasing, practice expenses continue to rise, and the oncology workforce is dwindling.”

 10/31/09­


 

ASCO CAC Network E-News
January 2010 Issue



Medicare Carrier Advisory Committee Update!!


Medical Specialty Societies Request that CMS Maintain the Integrity of the Carrier Advisory Committee as the Transition to MACs Continues
In December 2009, several medical specialty societies sent a letter to Charlene Frizzera, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS), requesting that CMS maintain the integrity of the current Carrier Advisory Committee (CAC) as the transition to Medicare Administrative Contractors (MACs) continues.  The joint society letter to Dr. Frizzera specifically requests the following:

     1.  Specialty Representation from Each State

The new Jurisdictional Advisory Committees (which would replace the current Carrier Advisory Committees if the proposed changes take place) should allow each state to have one representative per specialty (with an alternate) to ensure appropriate representations.  JAC representation, overall, should be encouraged to reflect the range of practice sizes, settings, and locations.


     2.  Annual Face-to-Face JAC Meeting

JACs should be required to hold at least one annual face-to-face meeting.  The annual JAC meeting should rotate through the MAC region to ensure access and convenience for all JAC representatives.

CMS has not yet responded to the letter.  We will keep you apprised of their response and of any new developments.


Medicare Contractor Updates (Non-Coverage)

CMS Imposes Documentation Request Limits on RACs

On December 2, 2009, the Centers for Medicare & Medicaid Services (CMS) announced new limits on the number of medical and related claims records that Recovery Audit Contractors (RACs) may request from hospitals and other providers in the course of an audit. RACs are charged on behalf of CMS with detecting and recovering improper Medicare payments (such as overpayments) to providers.

More information concerning the RAC announcement can be found on the
CMS website.

MUEs for Hospital Outpatient Added to CMS-Approved RAC Audit Targets
A new item has been added to the Connolly Healthcare website for Recovery Audit Contractor (RAC) review.  States affected include:  Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands, Virginia, and West Virginia.

Medically Unlikely Edits (MUEs) apply to all HCPCS/CPT codes that are above the maximum units of service that a provider should/would report for the same beneficiary, for the same date of service, and for the same provider. It has been discovered that more units were reported/billed for Medicare beneficiaries than what CMS has deemed "medically likely".

More information concerning the Connolly RAC announcement can be found in the following CMS manuals/publications:
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CMS Awards the Zone 5 Zone Program Integrity Contractor (ZPIC) Contract to AdvanceMed Corporation
Effective December 16, 2009, AdvanceMed Corporation became the Zone 5 Zone Program Integrity Contractor (ZPIC) for the Medicare and Medicaid Programs in Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. 

AdvanceMed has served the Medicare Program as a Program Safeguard Contractor (PSC) since 2002. The program integrity functions of the PSCs are being transferred to the ZPICs. This was mandated by the Medicare Modernization Act of 2003, which authorized CMS to contract with entities to fulfill program integrity functions for the Medicare program. As the ZPIC for Zone 5, AdvanceMed will perform benefit integrity activities aimed to reduce fraud, waste, and abuse in the Medicare (Part A, B, DME, Home Health and Hospice) and Medicare Medicaid Data Matching (Medi Medi) Programs. More information can be found in the Pinnacle
announcement.


National Coverage News

President Signs Short Term SGR Fix
The President has signed the law that will create a short term patch to Medicare's sustainable growth rate (SGR) formula, averting the 21 percent cut from taking place for two months. The patch runs through February 28, 2010. The SGR patch was included as a section of the FY 2010 Defense Appropriations bill.

ASCO, along with more than 50 physicians' organizations, sent a
letter last week urging Congress to take action for a permanent repeal of Medicare's SGR formula.

ASCO supports this interim measure of postponing the cuts for a period of 30-45 days two months, so that Congress has ample time to pass Medicare physician payment reform legislation. ASCO will continue to urge Congress to take immediate action to repeal the SGR formula in a way that is both fiscally responsible and in the best interest of cancer patients.

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

Important Update to the 2010 Medicare Physician Fee Schedule Conversion Factor!!
In a
correction notice published in the Federal Register on December 10, 2009, the Centers for Medicare & Medicaid Services (CMS) announced a correction to the conversion factor that was originally published in the Medicare Physician Fee Schedule Final Rule. (The conversion factor is the dollar amount published by CMS that is used to calculate Medicare payments.) The original conversion factor published in the 2010 MPFS Final Rule was $28.4061, but the corrected conversion factor is $28.3895.  CMS states the error was made in calculating the relative values for the consultation codes.

Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule (MPFS) for the first 10 business days of January (January 1 through January 15) for 2010 dates of service. All claims for services delivered on or before December 31, 2009, will be processed and paid under normal procedures.  After 10 business days, contractors will begin releasing held claims into processing under the fee schedule which implements current law (reimbursement currently remains at 2009 rate). 

Note:  If a new law is enacted, which would change the scheduled negative 21.2 percent update effective March 1, 2010, CMS will process claims under the new law and also reprocess any claims paid in error at the lower rate. 

More information concerning the 2010 Physician Fee Schedule payment rates can be found on the
CMS website

ASCO Comments on 2010 Physician Fee Schedule Final Rule
On December 29, ASCO submitted
comments to CMS in response to the Medicare physician fee schedule for Calendar Year (CY) 2010.

ASCO continues to oppose the elimination of the consult codes, and disagrees with CMS's rationale for doing so.

ASCO was pleased that CMS did not use the PPIS data for oncologists, but has encouraged CMS to update the Gallup survey data by a factor greater than the MEI.

ASCO Comments on HOPPS and CY 2010 Payment Rates
On December 29, ASCO submitted
comments to CMS regarding changes to the Hospital Outpatient Prospective Payment System (HOPPS) and calendar year (CY) 2010 payment rates.

ASCO expressed concern by the CMS finalized payment for separately payable drugs in the hospital outpatient setting at ASP + 4 percent. ASCO believes CMS is only allocating enough overhead to maintain an inadequate payment rate that does not cover the costs incurred by hospital to acquire and handle drugs. ASCO also is concerned about the decision to package all the 5-HT3 antiemetic drugs. ASCO believe that patients who undergo chemotherapy should have full access to antiemetic therapies their oncologists believe are most appropriate.

ASCO continues to support CMS's interest in establishing new quality reporting measure related to cancer and encourages CMS to work with ASCO on developing appropriate specifications and reporting measures.

CMS and MedCAC to Meet and Discuss Future Medicare Coverage Concerning Cancer Biomarkers and Cancer Drugs
On January 27, 2010, the Medicare Evidence Development & Coverage Advisory Committee (MedCAC) will be meeting with the Centers for Medicare & Medicaid Services (CMS) to discuss Medicare coverage concerning the pharmacogenomic value of cancer biomarkers and cancer drugs. 

MedCAC and CMS requested public comment concerning the following:

  • CYP2D6 and Tamoxifen.   Tamoxifen has been used as a valuable treatment for both early and advanced estrogen receptor positive breast cancer for over 30 years.  It is also approved by the FDA for the prevention of breast cancer in women at high risk of developing the disease.  The genetic test CYP2D6 identifies patients who may not receive full benefit from Tamoxifen because of too slow metabolism.
  • Her2/neu and Herceptin.  The genetic test HER2/neu is an important test because it identifies which patients should receive Herceptin with chemotherapy and thus greatly increase their chance for both survival and response rate.  Approximately 15-20 percent of breast cancers have an amplification of the HER2/neu gene (epidermal growth factor).  Overexpression of this receptor in breast cancer is associated with increased disease recurrence and worse prognosis.
  • UGT1A1 and Camptosar.  Camptosar is a valuable treatment for colon cancers but it can be associated with severe diarrhea and reduced white blood cells.  The genetic test UGT1A1 can identify patients in advance of receiving this drug so that appropriate management of the adverse effects can be implemented.
  • K-ras and Erbitux and Vectibix.  Erbitux and Vectibix are cancer drugs that block the growth of certain cancer cells especially in patients with metastatic colon cancer.   The genetic test K-ras identifies individuals that will not respond to these drugs.  This provides an evidence based way to select treatment for these patients that is more likely to be effective, thus avoiding exposure to adverse effects that would accompany an ineffective treatment.
  • BCR-ABL and Gleevec.  Gleevec is the cancer drug of choice for certain patients with chronic myelogenous leukemia (CML).  BCR-ABL or Philadelphia chromosome is a specific chromosone abnormality that is associated with some CML patients who are more likely to respond to Gleevec. 

More information concerning the scheduled January 27, 2010 MedCAC meeting can be found in the Federal Register , Vol. 74, No. 228 / 11/30/09. 

CMS No Longer Recognizes HCPCS Code Q2024 for Small Dose Bevacizumab (Avastin®)
The Centers for Medicare & Medicaid Services (CMS) no longer recognizes Healthcare Common Procedure Coding System (HCPCS) code, Q2024, for Bevacizumab (Avastin®) for payment of non-outpatient hospital claims. Practitioners must return to their previous reporting practice for small intraocular doses of Bevacizumab (Avastin®) furnished prior to October 1, 2009.  HCPCS code Q2024 has been deleted as of January 1, 2010, and, therefore, was also removed from the Average Sales Price (ASP) pricing file effective with the January 2010 Release.  Please verify with your local Medicare contractors concerning their new reporting and coverage requirements for this drug.

CMS Establishes HCPCS J-Code for Nplate® (Romiplostim)
Effective January 1, 2010, the Centers for Medicare and Medicaid Services (CMS) has established a Healthcare Common Procedures Coding System (HCPCS) J-code, or permanent code, for Nplate® (romiplostim).  The new code, J2796, for 10 mcg units of Nplate®, should be used instead of the current miscellaneous code, J3590, as well as the current C-code, C9245, when reporting a claim. The updated HCPCS table can be found on the
CMS website.  

CMS Ends Coverage with Evidence Development (CED) Requirements for FDG Pet for Cervical Cancer
Effective November 10, 2009, the Centers for Medicare & Medicaid Services (CMS), in
Change Request 6753 and MedLearn Matters, MM6753, announced a National Coverage Determination (NCD) concerning F-18 flouro-D-glucose (FDG) Positron Emission Tomography (PET) imaging for cervical cancer. Specifically, CMS has ended the coverage with evidence development (CED) requirements for FDG PET for cervical cancer; and will cover only one FDG PET for cervical cancer for staging in beneficiaries with biopsy-proven tumors when the treating physician determines that the study is needed to determine the location and/or extent of the tumor for specific therapeutic purposes related to initial treatment strategy (as outlined in the Medicare National Coverage Determination Manual, Section 220.6.17 (FDG PET for Oncologic Conditions (Various Effective Dates). 


Off-Label and Other Coverage Updates

JNCCN Issues New Colorectal Cancer Screening and Anal Cancer Guidelines

The January issue of JNCCN - The Journal of the National Comprehensive Cancer Network (Volume 8, Number 1) features two new NCCN Clinical Practice Guidelines in Oncology™:

      1. Colorectal Cancer Screening

Colorectal cancer mortality can be reduced through early diagnosis and cancer prevention with polypectomy. Although some screening techniques are better established than others, the guidelines panelists agree that any screening is better than none. Important updates for 2010 NCCN Guidelines for Colorectal Cancer Screening include the addition of surveillance guidelines and definitions for several polyposis syndromes, including Peutz-Jeghers syndrome and juvenile polyposis syndrome, and modifications to screening modality and schedule recommendations.

More information can be found on the NCCN website.

    2.   Anal Carcinoma

Although anal carcinoma is considered to be a rare type of cancer, its incidence has increased over the past 30 years. These NCCN Guidelines focus on managing squamous cell anal carcinoma, the most common histologic form of the disease. Updates for the 2010 NCCN Guidelines include new recommendations for treating metastatic disease and new principles of radiotherapy.

More information can be found on the NCCN website.



CMS News

CMS and ONC Issue Regulations Proposing a Definition of "Meaningful Use" and Setting Standards for Electronic Health Record Incentive Program

 CMS and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations that lay a foundation for improving quality, efficiency and safety through meaningful use of certified Electronic Health Record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).

A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of "meaningful use" of EHR technology. An Interim Final Regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations are open to public comment. Read the
press release, dated December 30, 2009, for more information.

The CMS proposed rule and fact sheets may be viewed at:
http://www.cms.hhs.gov/Recovery/11_HealthIT.asp

ONC's interim final rule may be viewed at:
http://healthit.hhs.gov/standardsandcertification

Additional website resources include:

  • Recovery Act Health IT website:

http://www.cms.hhs.gov/Recovery/11_HealthIT.asp

  • HHS Press Release:

https://www.cms.hhs.gov/apps/media/press_releases.asp


CMS Issues January 2010 ASP Pricing File
The Centers for Medicare & Medicaid Services (CMS) has released the January 2010 Average Sales Price (ASP) pricing file on their
website for providers to view and/or download. Please don't forget to update these prices in your practice management systems!

CMS Publishes New 2010 PQRI and E-prescribing Information
The Centers for Medicare & Medicaid Services (CMS) has published information on the 2010 PQRI and E-prescribing initiatives on its
website.  Specifics about the program, such as the 2010 PQRI measures list, the measure specifications, and an implementation guide, can all be found on the CMS website.

Note:  A new measure has been added for 2010 on oncology disease staging. Be sure to check the list to see what measures may be applicable to your practice.

CMS Issues Revised Guided Pathways Booklets
Are you wondering how to find the latest and greatest resources by subject?  The Revised Guided Pathways (NOV2009) booklets incorporate existing Medicare Learning Network (MLN) products and other centers resources into well organized sections that can help Medicare Fee-for-Service (FFS) providers and suppliers find information to understand and navigate the Medicare Program. These booklets guide learners to Medicare program resources, FFS policies and requirements.

Providers can access the
Revised Guided Pathways (NOV2009) booklets on the Medicare Learning Network.

CMS to Conduct Fifth Annual Medicare Contractor Provider Satisfaction Survey
The Centers for Medicare & Medicaid Services (CMS) is listening and wants to hear from you about the services provided by your Medicare Fee-for-Service (FFS) contractor that processes and pays your Medicare claims. CMS is preparing to conduct the fifth annual Medicare Contractor Provider Satisfaction Survey (MCPSS).  This survey offers Medicare FFS providers and suppliers an opportunity to give CMS feedback on their interactions with Medicare FFS contractors related to seven key business functions: Provider Inquiries, Provider Outreach & Education, Claims Processing, Appeals, Provider Enrollment, Medical Review, and Provider Audit & Reimbursement.

The survey will be sent to a random sample of approximately 30,000 Medicare FFS providers and suppliers. Those who are selected to participate in the 2010 MCPSS will be notified starting in January. If you are selected to participate, please take a few minutes to complete this important survey. Providers and suppliers can complete the survey on the Internet via a secure website or by mail, fax, or telephone.

To learn more about the MCPSS, please visit the
CMS website.

New Year Reminder Concerning the Coverage and Reporting for New Drugs & Biologicals
The payment allowance limits for new drugs and biologicals that are produced or distributed under a new drug application (or other new application) approved by the Food and Drug Administration, and that are not included in the ASP Medicare Part B Drug Pricing File or Not Otherwise Classified (NOC) Pricing File, are based on 106 percent of the WAC, or invoice pricing if the WAC is not published, except under OPPS where the payment allowance limit is 95 percent of the published AWP. This policy applies only to new drugs that were first sold on or after January 1, 2005. At the contractors' discretion, contractors may contact CMS to obtain payment limits for new drugs not included in the quarterly ASP or NOC files or otherwise made available by CMS on the CMS Website. If the payment limit is available from CMS, contractors will substitute CMS-provided payment limits for pricing based on WAC or invoice pricing.

If there is not a corresponding J code specific to the new drug, use the appropriate unlisted / not otherwise classified J code (J3490, J3590, or J9999) and submit the name, dosage, and NDC (National Drug Code) number. Lack of submission of any one of these items will result in a claims denial.

More information can be found in the CMS
IOM 100-04-Chapter 17; Section 20.1.3; paragraph 6; Chapter 1, Section 80.3.2.1.2, A. k. and CR 4140.

HHS Expands Medicare Fraud Strike Force Operations
The Department of Health and Human Services (HHS) now has three new Medicare Fraud Strike Force teams in Baton Rouge, Louisiana, Tampa, Florida, and in Brooklyn, New York. Thirty people have been charged in Miami, Detroit, and Brooklyn for their alleged roles in schemes to submit more than $61 million in false Medicare claims as part of the continuing operation of the Medicare Fraud Strike Force.  Five indictments were unsealed in Miami, Detroit, and Brooklyn, following the arrests of 25 individuals in Miami, four individuals in Detroit, and one in Brooklyn. In addition, Strike Force agents executed four search warrants at businesses and homes in Coconut Creek and Miami, Florida, as well as Brooklyn, New York.

In Miami, 15 individuals, including doctors and nurses, have been charged in connection with fraudulent claims to Medicare for Home Health services. In another case in Miami, individuals have been charged for their various roles in running a medical clinic that purported to provide injection and infusion treatments to HIV/AIDS patients, and submitted fraudulent claims to Medicare for such services, which were usually medically unnecessary and/or never provided.


ASCO Member News

Materials and Audio Recording Now Available Concerning ASCO's January 7th National Audio-Call on Adapting to Changes in Medicare for 2010

ASCO hosted a national audio-call on Thursday, January 7, 2010, on Adapting to Changes in Medicare for 2010. Topics covered on the call included an overview of Medicare's 2010 Physician Fee Schedule, highlights from Medicare's 2010 Hospital Outpatient Prospective Payment System, a review of the 2010 PQRI program and oncology-related measures, a review of the E-prescribing program, a Recovery Audit Contractor (RAC) overview, and an oncology coding update. 

The call materials and audio-recording replay instructions can be found the
ASCO website.  If you have any questions, please contact Jessica Perkins in the Cancer Policy and Clinical Affairs Department at (571) 483-1670.  Thank you very much!

ASCO Publishes "Improving Cancer Care: A Special Series" in Journal of Oncology Practice
JOP's newly published November issue carries a special series on Improving Cancer Care, with feature articles on the Quality Oncology Practice Initiative established by ASCO in 2002.  QOPI® promotes excellence in cancer care by providing oncologists an established and recognized way to examine the care they provide and measure the impact of improvement efforts.

Read more about the origins, development, success, and future of QOPI at:
http://jop.ascopubs.org.

QOPI Certification Opens Soon
The QOPI Certification application process launched on January 5, 2010. Practices that met QOPI Certification scoring requirements in the fall of 2009 have become the first eligible to apply for certification. QOPI Certification is based on select QOPI performance measures, and the new QOPI Certification Site Assessment which includes measures for practice safety and quality.

Practices interested in applying must have completed all of the applicable modules and met sample size requirements. Practices are encouraged to review the structural standards that will be assessed for the QOPI Certification Site Assessment and implement the quality improvements necessary to meet certification requirements before applying. In order to achieve certification, practices must demonstrate compliance with all standards.

The application process will be open until March, 24 2010. Practices will have the opportunity to apply for QOPI Certification following each round of QOPI. The next scheduled rounds are March/April 2010 and October/November 2010.

Questions about QOPI Certification should be directed to
qopicertification@asco.org. More information can be found at http://qopi.asco.org/certification.


FDA Updates

FDA Provides Recommendations Concerning the Safety of CT Brain Perfusion Scans
As of December 7, 2009, the U.S. Food and Drug Administration (FDA), working with state and local health authorities, has identified at least 50 additional patients who were exposed to excess radiation of up to eight times the expected level during their CT perfusion scans.  On the basis of its investigation to date, the FDA is providing interim recommendations for imaging facilities, radiologists, and radiologic technologists to help prevent additional cases of excess exposure.

   The new FDA recommendations include:

  • Facilities assess whether patients who underwent CT perfusion scans received excess radiation.
  • Facilities review their radiation dosing protocols for all CT perfusion studies to ensure that the correct dosing is planned for each study.
  • Facilities implement quality control procedures to ensure that dosing protocols are followed every time and the planned amount of radiation is administered.
  • Radiologic technologists check the CT scanner display panel before performing a study to make sure the amount of radiation to be delivered is at the appropriate level for the individual patient.
  • If more than one study is performed on a patient during one imaging session, practitioners should adjust the dose of radiation so it is appropriate for each study.
The MedWatch safety summary, as well as the FDA News Release, can be found on the FDA website.  


Local Coverage News

First Coast Creates Three New Local Coverage Policies, Effective January 25th

First Coast Service Options (FCSO), the A/B MAC contractor for Jurisdiction 9 (Florida, Puerto Rico, and U.S. Virgin Islands), has created the following three new local coverage determinations (LCDs), all effective as of January 25, 2010:

1/12/10

 PUBLIC COMMENT REQUESTED


 Contact Your Senators About Co-Sponsoring Proposed ASP Reform

S 1221-A bill to amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's average sales price.

To express support for this reform, members may contact their senator's Health LA (legislative assistant) to ask their Senator to co-sponsor Senate Bill S1121 as well as support the issue if and when it comes up as an amendment to the HCR. (Health Care Reform Bill) .

 

NH

Judd Gregg

Health Legislative Assistant:

Elizabeth Wroe-- elizabeth_wroe@gregg.senate.gov­

­

Jeanne Shaheen

Legislative Assistant

Alison MacDonald

alison_macdonald@shaheen.senate.gov 

  

VT

Patrick Leahy

Health Legislative Assistant

Kathryn Neal-- kathryn_neal@judiciary-dem.senate.gov

Bernie Sanders

Health Legislative Assistant

Daniel Keeney daniel_keeney@sanders.senate.gov

 

ME

Susan Collins

Health Legislative Assistant

Priscilla Hanley priscilla_hanley@collins.senate.gov

Olympia Snowe

Health Legislative Assistant ­

­Bill Pewen bill_pewen@snowe.senate.gov

 
UPCOMING OPPORTUNITIES


 ­RESOURCES

Oncology Practice Insider

ASCO's e-Digest for Practice Management ~ edited by NNECOS Board Member Elaine Towle, CMPE

January 26, 2010

Welcome to Oncology Practice Insider.  Our lead story in this issue is a reminder about the new 2010 rules for billing consultations for Medicare patients.  If you haven't yet made these changes in your practice, be sure to read this article as well as the Medicare instructions in MM6740.  We also include a reminder about the 2010 PQRI program and links to both the ASCO measure table and the AMA PQRI tools for each measure.  Check these out and position your practice to earn the 2% PQRI incentive in 2010.  As always, please contact us at practice@asco.org if you have questions, comments or suggestions for future content.

 


Contents:

1. Review of CMS' Rules on Consultation Codes
2. UnitedHealthcare's Rules on Consultation Codes
3. Notice of New Interest Rate for Medicare Overpayments and Underpayments
4. January ASP Files
5. 2010 PQRI Program & Tools
6. CMS Open Door Forum Call - February 2nd
7. Revised Medicare Physician Guide
8. ASCO's Coding & Reimbursement Services
9. Did you know?...


 

ASCO Express provides updates on time sensitive, pertinent matters.

Cancer Policy and Health Care Priorities provides up-to-date information on action ASCO is taking to fight  fee schedule cuts, and to make the voice of the oncologist heard in health care reform debates.

ASCO's Grassroots Action Center ; If you have any questions, please contact ASCO's Cancer Policy and Clinical Affairs Department at 571-483-1670 or grassroots@asco.org.

ASCO's EHR social networking site: http://ehr.ascoexchange.org

Chemoprevention Discussion Guide 

UnitedHealthcare Access to the NCCN Compendium for UnitedHealthcare coverage: Registered users of UnitedHealthcareonline can access the NCCN Compendium page for free. Login to the UnitedHealthcareonline page,  proceed to the NCCN Compendium page.  From there, you can log in to www.NCCN.org for free access to the NCCN Drugs and Biologics Compendium. 

Enhancing Clinical Trial Awareness and Outreach

Reimbursement, Billing, and Coding Article: Can patient care and joint ventures co-exist?


 What You Need to Know About the Impact of the  American Recovery and Reinvestment Act (ARRA) on Oncology and Electronic Health Records (EHR) Use

With the signing of the American Recovery and Reinvestment Act (ARRA), allocating approximately $19 billion towards Electronic Health Record (EHR) adoption, physicians who demonstrate meaningful use of certified EHRs could be eligible for up to $44,000 in incentives over five years beginning in 2011. Defining the standards for qualified EHRs, as well as the "meaningful use" requirements for physicians using qualified EHRs, will be key to the way these incentives are earned. To qualify, as a "meaningful EHR user" physicians will need to:

• Use a certified EHR product that complies with federal standards for interoperability, or sharing data between electronic systems;
• Use e-prescribing software;
• Use a certified EHR to exchange health information to improve the coordination and quality of care; and
• Use a certified EHR to electronically report on the quality of care.

The Department of Health and Human Services is required to adopt, through the regulatory rule-making process, an initial set of standards, implementation specifications, and certification criteria by December 31, 2009.

ASCO has provided comment on the initial definition of “meaningful use” to highlight the needs of oncology. 

  7/23/09


­Peer Reviewed Canc­er Information for Patients

Good cancer care starts with good cancer information. Well-informed patients are their own best advocates and invaluable partners for physicians. ASCO’s patient website, Cancer.Net, provides trusted, authoritative information for people living with cancer and those who care for and about them. All of the information on Cancer.Net is reviewed by oncologists and other oncology professionals who are ASCO members, making Cancer.Net a current and trusted resource for cancer information.

 Following is a list of information people will find on Cancer.Net:

 Cancer.Net Guides to Cancer: Detailed guides about a specific type of cancer, including symptoms, risk factors, diagnosis, staging, treatment, clinical trials, follow-up care, and questions to ask the doctor.

 Cancer.Net Features, including ASCO Expert Corner interviews: Weekly articles designed to provide in-depth information on topics of interest, as well as practical information on cancer care and treatment.

 Find an Oncologist: Search the database of ASCO members who have made their contact information public.

 Clinical Trials:  Information on clinical trials and patient safety, steps involved in the research process, risks and benefits of participating in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.

Cancer.Net Podcasts: Information on cancer research, treatment, coping, and many other topics through audio podcast.

 Medical Illustrations Gallery:  Full-color anatomical and staging illustrations organized by cancer type, including a version that can be downloaded and printed on an 8.5" x 11" page.

 Cancer.Net En Español: Information in Spanish on 25 cancer types, side effects, patient guides based on ASCO clinical practice guidelines, clinical trials, and information on tobacco and cancer.

Cancer Advances: News for Patients: Summaries of cancer research presented each year at ASCO's Annual Meeting.

What to Know: ASCO’s Guidelines for Patients: Patient-friendly guides based on ASCO's Clinical Practice Guidelines for physicians.

For free Cancer.Net promotional materials to share with patients, including referral cards, leaflets, cancer information prescription pads, or posters call 888-651-3038 or send an email to contactus@cancer.net.

4/28/09







Northern New England Clinical Oncology Society
P.O. Box 643
Sandown, NH 03873-0643
Telephone (603) 887-1948
nnecos@comcast.net

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