November 2012 Practice Update (part one)

2012-11-08

YOUR INPUT IS NEEDED: AMA RUC Survey of the Infusion and Chemotherapy Services
On November 7, ASH in collaboration with multiple specialty societies, randomly distributed an American Medical Association Relative Value Scale Update Committee (RUC) survey of the infusion CPT codes 96365, 96366, 96367, 96368 and the chemotherapy infusion CPT codes 96413, 96415 and 96417 to a high percentage of our members. These services are utilized widely by our members and we need your assistance, to assure the relative value units (RVUs) are accurately and fairly presented to Centers for Medicare and Medicaid Services (CMS). This is important to you and other physicians because the RVUs determine the rate at which Medicare and other payers reimburse for services and procedures. The survey closes at midnight on Wednesday, November 21, 2012.

If you received the survey, please complete it. If you did not receive the survey, there is a chance that it was caught in your spam or junk e-mail folders, please check these folders to see if you received the survey message. Please contact ASH Government Relations and Practice Manager Stephanie Kaplan (skaplan@hematology.org or 202-776-0544) if you have any questions.

News from Medicare

New Medicare & Medicaid Regulations Benefit Hematologists; ASH Advocacy Improved Physician Payment
ASH's advocacy efforts were instrumental in making hematologists eligible for enhanced payments within the 2013 Medicare Physician Fee Schedule rule. Payment rates for hematology/oncology services will increase by 2 percent based on the changes made in this rule. In addition, CMS proposed payment for two new codes for transitional care management (TCM) services provided to patients being discharged from acute, rehabilitation, or long-term acute hospital stays into the community. Primary care providers and specialists can bill these for new services within 30 days following discharge. ASH advocacy also influenced the Medicaid rule implementing a provision of the Affordable Care Act stipulating that Medicaid reimbursement for certain primary care services equal Medicare rates in 2013 and 2014. While originally thought to only apply to physicians who are board-certified in family medicine, internal medicine or pediatrics, the final Medicaid rule included subspecialists in these fields and will result in increased payments for adult and pediatric hematologists. Read more.

These changes do not factor in the looming 27 percent cut in Medicare physician payment if Congress does not avert scheduled cuts by January 1, 2013. Additional advocacy is needed to assure that physician payment is not cut in January. Please visit ASH's Advocacy Center to send a letter to your Representative and Senators today.

ASH Comments to CMS Re: National Coverage Determination (NCD) on Aprepitant for Chemotherapy-Induced Emesis
ASH submitted comments to CMS in support of The National Comprehensive Cancer Network's (NCCN) request for a reconsideration of the April 4, 2005 National Coverage Determination (NCD) concerning Aprepitant for Chemotherapy-Induced Emesis (110.18). Aprepitant is currently covered under the Oral Antiemetic Drug benefit category. Since the Aprepitant NCD became effective in 2005, the manufacturer received expanded FDA approval for aprepitant use in the prevention of nausea and vomiting associated with moderately emetogenic chemotherapy (MEC). The combination of dexamethasone and palonosetron has been shown to be superior to dexamethasone plus dolasetron, granisetron or ondansetron in preventing nausea and vomiting associated with MEC or with highly emetogenic chemotherapy (HEC). ASH and the NCCN urged the Centers for Medicare and Medicaid Services to update the NCD since the emetogenic classifications have been revised to include new anticancer chemotherapy agents and evidence based guidelines have also been updated and published. Read more.

News from the FDA

FDA Grants Accelerated Approval To Omacetaxine Mepesuccinate For Treatment Of Adult Patients With CML Resistant/Intolerant To Two Or More TKIs
On October 26, 2012, the U. S. Food and Drug Administration granted accelerated approval to omacetaxine mepesuccinate, (SYNRIBO® for Injection, for subcutaneous use, Teva Pharmaceutical Industries Ltd.), for the treatment of adult patients with chronic or accelerated phase chronic myeloid leukemia (CML) with resistance and/or intolerance to two or more tyrosine kinase inhibitors (TKIs). The accelerated approval was based on combined data from two open label single-arm trials enrolling patients with CML in chronic phase (CML-CP) or in accelerated phase (CML-AP). Read more.

News from ASH

ASH's 2012 Clinical Practice Guide on Red Blood Cell Transfusion is Available
ASH's newest pocket-sized quick reference guide on red blood cell transfusion is available. The guide was adapted from "Red Blood Cell Transfusion: A Clinical Practice Guideline from the AABB" Ann Intern Med. 2012; 157: 49-58. To obtain hard copies of the ASH 2012 Clinical Practice Guide on Red Blood Cell Transfusion, please contact ASH Policy & Practice Coordinator Patrick Irelan at pirelan@hematology.org. A list of ASH's previously published pocket guides and mobile downloads of the pocket guides is available on the ASH website.

ASH Choosing Wisely Campaign
ASH is in the process of identifying an evidence-based list of the five hematological tests, procedures and/or treatments physicians and patients should question as part of the ABIM Foundation's Choosing Wisely Campaign. The campaign is a multi-phased national effort in partnership with medical specialty societies to promote appropriate medical decision making. Choosing Wisely hopes to encourage the important dialogue between physicians and patients about medical tests and procedures that may be unnecessary, and in some instances cause harm. ASH continues to welcome input from all of its members; if you are interested, please contact Suzy Leous at sleous@hematology.org. For more information on the Choosing Wisely Campaign, please visit www.choosingwisely.org.

ASH Annual Meeting: Practice-Related Events
Please join us at the following special practice-related events at the ASH Annual Meeting and Exposition:

For more details and registration information about these practice-related events, read more.

Earn CME Credits from Blood
ASH, in partnership with Medscape, provides monthly opportunities to earn Continuing Medical Education (CME) credits by completing an Accreditation Council for Continuing Medical Education (ACCME) accredited activity in Blood. This month's activity is titled "Outcome of Hematopoietic Stem Cell Transplantation for Adenosine Deaminase-Deficient Severe Combined Immunodeficiency."

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