Welcome to our members' forum, a repository of news about initiatives and activities impacting our region. The information below is divided into four sections, PUBLIC COMMENT REQUESTED, UPCOMING OPPORTUNITIES, RESOURCES, and ANNOUNCEMENTS. If you'd like information about your initiative or activity posted, check out the News Release Criteria.
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) .
Olympia Snowe Health Legislative Assistant Bill Pewen bill_pewen@snowe.senate.gov
UPCOMING OPPORTUNITIES
COLLABORATIVE RESEARCH FUNDING OPPORTUNITY
The Northern New England Clinical Oncology Society (NNECOS) is pleased to announce a collaborative research funding opportunity. Up to $20,000 in grant funding will be awarded. Complete details are available on our Research Funding page.
5/20/09
RESOURCES
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.
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
NCI Promotional Tools Increase Awareness of Clinical Trials The National Cancer Institute (NCI) announces the availability of two new patient education posters and a pin to increase awareness about clinical trials. Their purpose is to begin the discussion with cancer patients that a trial may be a reasonable option in the continuum of their cancer care.
These new posters and pins will introduce patients to the concept of a clinical trial, complement education and recruitment efforts, and serve as conversation starters to discuss trials in a larger context before exploring specific trials with patients. The pins can also be worn by patients participating in clinical trials including their family and friends so they can all help in the effort to increase awareness.
We hope these new materials are helpful to you in your recruitment efforts!
I had the pleasure of participating in ASCO's EHR Lab at the
recent ASCO Annual Meeting in Orlando. There was a lot of interest in
this year's Lab, fueled in part I suspect, by the stimulus funds that become
available starting in 2011 for physicians that can demonstrate "meaningful
use." Ten EHR vendors met ASCO's requirements for admission to the
Lab this year. If you are looking for an EHR, be sure to check out the
vendor directory, a great tool as you begin the process. And don't forget
the 2009 ASCO EHR Symposium on October 6-7 in San Francisco. Visit the ASCO
website for more information and updates.
The Oncology Practice Insideris an
interactive bi-weekly communication designed for oncology practice management
professionals. Send us your feedback and suggestions for future issues at
practice@asco.org.
The
recent growth of online social networks has been remarkable, with sites such as
MySpace, Linked-In and Facebook receiving millions, and even tens of millions
of members. A variety of other networking sites have been developed as well,
serving specific user communities. Along these lines, ASCO has developed a new
electronic health record (EHR) social networking site that enables oncologists
and their practice staff to easily connect, collaborate, and find information
on EHRs and health information technology.
You are invited to join ASCO's new EHR social networking
site at http://ehr.ascoexchange.org. You will
have an opportunity to view and participate in discussion forums, start blogs,
and engage in EHR vendor user groups. Widgets and RSS feeds can be
incorporated into your own personal page on the site and you can invite fellow
colleagues to join the site as well.
The
role of social networks in medicine is just beginning to be understood. In an
era of rapid medical change, the need to develop richer and more varied sources
of information and the value of far-reaching, online social trust networks will
become increasingly apparent for the medical field. Oncologists can be at
the forefront of this communication-rich platform and use it to increase
understanding and awareness of EHRs and health information technology.
Please
sign up today at http://ehr.ascoexchange.org to join
this important ASCO network and feel free to forward this invitation to
practice staff or other colleagues who might find the site useful.
What’s
a good way to discuss cancer chemoprevention with interested patients?
Decision Aids and Discussion Guides showing and describing risks and benefits
can help shared decision-making. Check out ASCO’s new Discussion Guide on
chemoprevention for prostate cancer using finasteride, based on a newly
published joint guideline with the American Urological Association.
The
Discussion Guide graphically demonstrates the benefits and risks in terms of
prostate cancer incidence, shows the likelihood of other risks and benefits,
and includes ways for men to think over this topic.
We invite you to share this free online resource with your primary care
colleagues. www.asco.org/guidelines/5ari
2/27/09
ANNOUNCEMENTS
NIH and NCI Announce Recovery Act Funding Opportunities; Recent New York Times Articles Highlight Cost of Cancer Drugs
Recent New York Times Articles Highlight Cost of Cancer Drugs
Last week, The New York Times
published an article, “As Pills Treat Cancer, Insurance Lags Behind,”
highlighting issues faced by some people with cancer who are prescribed
oral chemotherapy treatments. Unlike infused chemotherapy drugs, oral
chemotherapy is typically covered under prescription drug plans, which
can require higher patient co-pays. As a result, many patients are
facing challenges paying for their chemotherapy treatment.
ASCO believes people with cancer should receive the best treatment
available to appropriately treat their disease. As more oral
chemotherapy drugs are developed, these issues outlined in the New York
Times article will only grow. ASCO’s Cost of Cancer Care Task Force is
setting priorities to help ensure that cost is not a barrier to
treatment for patients. The Task Force’s first step is developing
tools and resources to improve communication between patients and physicians about the costs of cancer care.
ASCO also will publish a cost of care guidance statement in the
Journal of Clinical Oncology
in July, which will overview the economic issues facing doctors,
patients, and other stakeholders and highlight ASCO’s plan for
addressing the increasing costs of cancer care.
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or
publicpolicy@asco.org.
4/28/09
NIH and NCI Announce Recovery Act Funding Opportunities
On April 20, National Cancer Institute (NCI) Director John E.
Niederhuber, MD, announced major details about the Institute’s plan to
use the stimulus funding allocated in the American Recovery and
Reinvestment Act. NCI plans to fund projects that will:
Increase the NCI payline to fund a greater number of meritorious investigator-initiated projects.
Provide additional grants to first-time investigators.
Provide funding to universities to assist and train new faculty investigators.
Develop a personalized cancer care platform to encompass and enable drug development.
Establish a new network of Physical Sciences-Oncology Centers to converge the physical science with cancer biology.
Expand the Cancer Genome Atlas.
On April 13, the National Institutes of Health (NIH) highlighted a new grant program, the Research and Research Infrastructure "Grand Opportunities,"
which will support nearly $200 million in large-scale projects that
have a high likelihood of enabling growth and investment in biomedical
research and development, public health and health care delivery. Grant
applicants can propose projects that address either a specific research
question or create a unique infrastructure/resource to accelerate
scientific progress in the future. Applications are due May 27.
NCI also is asking researchers to submit requests for supplemental
funding in FY 2009, to support and encourage new multidisciplinary
scientific collaborations through the NCI-Activities to Promote
Research Collaboration (NCI-APRC) program. Funding applications are due
May 1, and requests should be for existing NCI-funded research
projects. Guidelines and more information about NCI-APRC are available
on the NCI Web site.
4/28/09
A Letter from Dr. Lee Newcomer, United HealthCare
UnitedHealthcare is requiring submission of the
KRAS gene report for colorectal cancer patients and
we are providing
free access to the NCCN Compendium for physicians treating UnitedHealthcare
patients.
KRAS gene requirement for cetuximab
and panitumumab in colorectal cancer
Effective April 1, 2009,
UnitedHealthcare will require the submission of a pathology report
documenting a wild type KRAS gene for coverage of Erbitux®
(cetuximab J9055) and Vectibix® (panitumumab J9303) in the treatment of
metastatic colorectal cancer. As always, final coverage is subject
to the member’s benefit plan document.
UnitedHealthcare has contracts with two national laboratories
(Genzyme Genetics and LabCorp) that provide KRAS testing. Specimens
may be sent directly to these laboratories; claims for members that are paid on
a fee for service basis (non capitated) will be paid directly to the
laboratories by UnitedHealthcare. Both laboratories request that a copy
of the pathology report be sent with the specimen. If your local
participating laboratory provides this test it will also be covered.
Requirements:
The submission of a KRAS pathology report
is required for members starting therapy using cetuximab or panitumumab
after the implementation date. Only one pathology report per member
ID is required.
Physicians will not be required to submit
pathology reports for individuals that were on cetuximab or panitumumab
prior to the effective date for the plan's policy.
The policy applies to those individuals
where UnitedHealthcare or one of its affiliated entities is the primary
payor.
Pathology reports are NOT required if
UnitedHealthcare or one of its affiliated entities is the secondary payor.
For UnitedHealthcare patients: Fax a copy of the
pathology report to (915) 231-1970 using the KRAS fax coversheet. The
coversheet is available at UnitedHealthcareOnline.com >Cancer - Oncology
> KRAS > KRAS Fax Coversheet. You may use this process and submit your
claims electronically.
For Oxford patients: Oxford will also require the KRAS
pathology report for individuals starting cetuximab and panitumumab
therapy 4/1/09. Providers are required to obtain prior authorization
for the use of cetuximab and panitumumab for patients with colorectal
cancer. Prior authorization requirements include the submission of
the laboratory report demonstrating the presence of the KRAS wild type
gene. Providers should follow the standard prior authorization process.
Additional information regarding the implementation of this policy
for UnitedHealthcare and its entities is available at
UnitedHealthcareOnline.com and on the other health plan websites.
Lee Newcomer comments: UnitedHealthcare had a similar process
for the HER2 gene and trastuzumab coverage. During the two years the edit
was active we noted that the billing offices frequently sent the wrong
clinical records. We only need the copy of the laboratory report
documenting the KRAS gene type. Please do not send pathology reports,
clinic notes, discharge summaries or other unrelated materials. It
may be beneficial for the clinicians to teach the billing staff what document
to send for this review.
Access to
the NCCN Compendium for UnitedHealthcare coverage
The National Comprehensive Cancer Network (NCCN) has announced
that effective April 1, 2009 they will require a paid subscription for access
to the NCCN Drugs and Biologics Compendium.
As you already know, UnitedHealthcare uses this document as a reference
for coverage decisions.
UHC recognizes the value of the NCCN Drugs and Biologics Compendium
in physician practices and has purchased a group rate. We are pleased to offer FREE access to the
NCCN compendium to our UHC participating physicians and their office staff.
To access the NCCN Drugs and Biologics Compendium under the UHC agreement,
you will need to be a registered user of UnitedHealthcareonline. Once you are logged into our website, 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.
If you are not a registered user of UnitedHealthcareonline, go to
the New User link in the upper right corner of the home page and register.
Please share this email with others in your office that accesses
the NCCN Compendium.
Lee N. Newcomer, M.D.
UnitedHealthcare Oncology
5901 Lincoln Drive, MN012-S210,
Edina, MN 55436
Phone: 952 992 4025
3/31/09
CMS News
CMS Resumes Recovery Audit Contractor
Program The Tax Relief and Health Care Act of 2006, Section 302, requires a
permanent and nationwide RAC program no later than 2010. There are a
total of four RACs nationwide, which were announced back in October 2008.
On November 2, 2008, however, two of the RAC contracts were disputed, and the
Government Accountability Office (GAO) issued a "Stay of Work", or
hold, on the implementation of the four RACs.
On February 2, 2009, the companies involved in the RAC contract dispute reached
a settlement, and on February 4, 2009, the "Stay of Work" was
lifted. CMS states it will begin contacting
associations and providers to discuss provider outreach sessions involving the
RACs over the next few months. For additional information on the RAC program,
visit the CMS
website.
3/12/09
UNITED HEALTHCARE UPDATE 3/8/09
UnitedHealthcare Premium physician designation program changes for oncologists
The
UnitedHealth Premium® physician designation program for oncology is changing. In
the past, oncologists were invited to participate in the program by completing
a survey about important clinical characteristics regarding their individual
practice. Those who submitted a survey response and met the program
requirements were recognized in our online Web sites with the Quality
designation.
The
UnitedHealth Premium designation program, which has evaluated physicians in 21
different specialties, continues to evolve based upon the input of practicing
physicians and medical specialty societies. As a result of this input,
UnitedHealthcare has decided to discontinue the current, survey-based approach
to Premium designation for oncology.This spring, our online directories will display
“Specialty Not Evaluated” next to the name of network oncologists. This is how
we currently display the names of other physicians who are in specialties that
are not evaluated in the Premium designation program.
We
will continue to work with oncologists and their specialty organizations to
develop programs that support practice improvement. For example, in the future,
we will recognize physicians on our consumer Web sites, for their participation
in the American Society of Clinical Oncology’s Quality Oncology Practice
Initiative program (QOPI®). Additionally, we are testing a set of
measures for oncology quality and cost efficiency based on national standards
from specialty societies and the NCCN. Only after these measures are validated,
will they be used in the future releases of the UnitedHealth Premium
designation program for oncology.
If you would like
more information on these changes or the QOPI recognition program, please go to
the “News” section of our physician portal at www.UnitedHealthcareOnline.com.
We will post news articles throughout the year as updates are made. You can
also call our Premium program line toll-free at (866)
270-5588.
All of our contracted
physicians will recieve a letter this week notifying them of the change in our
program.
3/9/09
NNECOS RECEIVES $10,000 ASCO GRANT Tri-State Group Studying Barriers to Clinical Trials Participation
The NNECOS Board of Directors is pleased to announce the receipt of a $10,000 ASCO State Affiliate grant in support of the tri-state clinical trials project. A group of community oncologists from across the region are studying cost as a barrier to clinical trial participation in Northern New England. Principal investigators for this project are: Douglas Weckstein MD, NH Oncology Hematology PA; Ivette Emery, PhD, Maine Center for Cancer Medicine; Christian Thomas MD, Vermont Center for Cancer Medicine; and Barbara Shea MD, Seacoast Cancer Center. The project is also supported by $11,700 in NNECOS funds.
This team has developed a protocol to assess the reasons that patients decline or are unable to participate in clinical trials. The survey will be issued to patients in four community based oncology practices in Northern New England with established clinical trial programs. The practices provide a cross-section of geographic, economic, and clinical trial infrastructure conditions. Grant funding will cover the cost of postage and three daytime investigator meetings. The team hopes to utilize the data obtained from the study to devise targeted strategies to ameliorate barriers to trial participation that exist in the community oncology practice setting.
In approving this grant request, the board expressed great enthusiasm for this strategically important project whose goal is in direct alignment with NNECOS’ mission “to ensure the availability of and access to high quality oncology care in our region,” which is also an excellent complement to our ongoing access to care study being conducted with state cancer registries from Maine, New Hampshire, and Vermont.
The board has invited the team to present findings at a future NNECOS meeting.
2/3/09
Northern New England Clinical Oncology Society P.O. Box 643 Sandown, NH 03873-0643 Telephone (603) 644-5273 nnecos@comcast.net
