2009-11-23

Senate Votes to Advance Health Reform Legislation; Debate & Votes Expected to Begin After Thanksgiving
During a rare Saturday vote on November 21, the U.S. Senate voted 60-39 to allow debate to proceed on health reform legislation crafted by the Democratic leadership. Read more.

House Passes Medicare Physician Payment Bill
By a vote of 243-183, the House passed a bill (HR 3961) that would block a 21 percent scheduled cut in Medicare’s payment rate for physician services that is scheduled to take effect in January. The Senate is addressing the physician payment cut in its version of health reform (HR 3590). The Senate bill includes a provision that would avert the planned 21 percent Medicare payment cut next year through a one-year fix of the Medicare physician payment formula that would increase payment rates by 0.5 percent.

ASH Provides Summary and Analysis of Final Medicare Physician Fee Schedule Rule
On October 30, the Center for Medicare & Medicaid Services (CMS) released its final rule that updates payment policies and rates under the Medicare Physician Fee Schedule for calendar year 2010 beginning January 1, 2010. ASH has prepared a summary and analysis of the final rule. Read more.

ASH Provides Summary and Analysis of Final 2009 Final Hospital Outpatient Prospective Payment System Regulations
On October 30, CMS released the final 2010 Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center Rule. ASH has prepared a summary and analysis of the final rule. Read more.

ASH Comments on AHRQ Report on Off-Label Indications for Targeted Therapies Used in Cancer Treatment
The Agency for Healthcare Quality and Research (AHRQ) requested comment on its Report on the Evidence Regarding Off-Label Indications for Targeted Therapies Used in Cancer Treatment. ASH commented that it is a challenge to have randomized controlled trials or comparative effectiveness research of sufficient rigor for many of these rare diseases and, therefore, the use of an off-label indication may be a reasonable clinical decision. ASH also provided specific comments on methodology, importance of currency, and references.

CMS Proposes National Coverage Decision: Stem Cell Transplant in Myelodysplastic Syndromes
CMS is inviting public comments on a proposal to reimburse allogeneic stem cell transplantation for myelodysplastic syndromes (MDS). A positive decision would provide reimbursement for stem cell transplants before the disease progresses to acute myeloid leukemia and other complications. This proposal is in response to an ASH request to develop a national coverage decision (NCD) addressing allogeneic stem cell transplant for the MDS patient. Lack of a national Medicare policy has meant that coverage is inconsistent. Whether a transplant is covered often depends on the region in which the patient lives.

Comments are due on December 10. ASH encourages you to provide positive comment to assure that CMS approves this NCD.

2009 PQRI National Provider Call With Question & Answer Session
The CMS Provider Communications Group will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place from 1:30 - 3:30 p.m. EST, on Thursday, December 10, 2009. Call participants can register and access a transcript one week after the call on the CMS Web site.

The topics covered on this national provider call will include:

• Alternate feedback report request process
• Update on incentive payments and feedback reports
• Results from the 2008 PQRI and 2007 PQRI re-run
• Measures issues identified in 2008 PQRI

Medicare Average Sales Price Updates Available
CMS has made the Medicare Part B Drug and Biological Average Sales Price Payment Amounts for January 1, 2010, through March 31, 2010, available on the CMS Web site.

Implementation of Red Flags Rule Delayed Until June 2010
Federal Trade Commission announced that the Red Flags rule will be delayed until June 1, 2010. The Red Flags rule would require physicians to develop and put into practice written identity theft prevention and detection programs. There is debate about whether physicians should be considered to be "creditors" and subject to the rule. Read more. 

ASH Annual Meeting: Policy & Practice Events You Will Want to Attend
This year’s ASH annual meeting in New Orleans has several events that you should plan to attend, including the Special Quality Symposium: Supply & Demand: Ensuring an Adequate National Blood Supply and the Practice Forum: New American Health-Care Policy and the Practice of Hematology. Read more.