2010-03-25

Historic Health-Care Reform Signed Into Law
On March 23, President Obama signed the Senate version of a health-care overhaul bill (HR 3590) into law after passage by both houses of Congress. Now, the U.S. Senate is focusing on a separate “reconciliation” measure (HR 4872). This measure was passed by the U.S. House of Representatives and addresses many of the concerns that the House of Representatives had with the Senate health-care overhaul bill. The reconciliation process will shield the measure from filibusters; however, Senate Republican opposition is still expected to slow down the process by offering many amendments and raising objections to the bill. Read more.

ASH is reviewing the health reform and reconciliation package and will be providing an analysis of its impact on hematologists on the ASH Web site.

Physician Payment Cuts Scheduled to Begin April 1; Contact Congress Now to Stop the 21 Percent Cut
Health-care overhaul legislation may have been enacted into law, but a pay cut for Medicare reimbursements to physicians still looms at the end of March. ASH and other medical societies continue to pursue a permanent fix for the Medicare physician payment system.

Please join ASH’s advocacy campaign to urge the House and Senate to protect physician access to Medicare and TriCare beneficiaries. It is critical that all members of Congress hear from their physician constituents about the need to prevent the 21 percent Medicare payment cut scheduled to begin April 1. Read more .

Clinical Trials Coverage Provision Included in Final Health Reform Bill
An ASH-supported provision to require coverage of routine patient costs associated with clinical trials participation has been included in the health reform bill (HR 3590) signed into law by President Obama on March 23. Read more.

FDA Launches New Safety Program for ESAs March 24; ASH Clarifying Requirements for Hematologists Who Treat Anemia not Caused by Cancer
Beginning March 24, 2010, the Food and Drug Administration (FDA) will require that erythropoiesis-stimulating agents (ESAs) be prescribed and used under a risk management program, known as a risk evaluation and mitigation strategy. Since the FDA announced the program, ASH has been working to clarify how the program will apply to hematologists who prescribe ESAs for anemia not caused by cancer. Read more.

President Obama Announces New Fraud Control Initiatives
On March 10, 2010, President Obama announced expanded fraud and abuse control initiatives for Medicare, Medicaid, and other federal programs. The announcement included an Executive Order that directs all federal agencies (not just health-care agencies) to expand and intensify their use of “payment recapture audits” also known as Recovery Audit Contractors program. The new program will essentially expand the government’s ability to fund audits. Read more.

ASH Comments on Proposed Rule for Electronic Health Record Incentive Program
On March 15, ASH and other physician organizations provided comments to the Centers for Medicare & Medicaid Services (CMS) in response to its proposed rule for implementing the Medicare and Medicaid electronic health record (EHR) incentive programs required by the American Recovery and Reinvestment Act of 2009. The comments expressed concern that the criteria proposed by CMS for achieving meaningful use of EHRs is overly aggressive and, if adopted, will deter many physicians from participating in the Medicare and Medicaid incentive programs. Additional information is available.

Medicare Requires Physicians to Update Enrollment Information in PECOS to Receive Payment
Physicians who have not updated their enrollment information since the Medicare Provider Enrollment Chain and Ownership System (PECOS) database was created in 2003 need to respond to a letter from their Medicare contractor requiring them to "revalidate" their information. Read more.

Highmark’s Updated Policy on ESAs is Now Active
Highmark Medicare Services, Inc. recently updated its Local Coverage Determination (LCD) on ESAs; all changes became effective on March 10, 2010. The Society is pleased to see that the updated LCD is consistent with ASH's Model Policy: Indications for ESA Treatment for Patients with Myelodysplastic Syndromes (MDS). The policy covers states in MAC Jurisdiction 12 including: Delaware, Washington, DC, Maryland, New Jersey, and Pennsylvania.

If you have additional questions or would like further information, please contact ASH Government Relations Manager, Stephanie Kart, at 202-776-0544.

FDA 'Black Box' Warning on Blood Thinner Plavix
The Food and Drug Administration (FDA) announced a black box warning for the antiblood clotting drug Plavix (clopidogrel), alerting patients and health-care professionals that the drug can be less effective in people who cannot metabolize it to convert the drug to its active form. Read more.

Medicare Releases Updates of the Hospital Outpatient Prospective Payment System (OPPS)
CMS has released an Update of the Hospital Outpatient Prospective Payment System (OPPS). The update includes issues of interest to hematology. These updates will go into effect on April 1, 2010. Read more.

Medicare Releases Updates of the Quarterly Average Sales Price (ASP)
CMS has released and provided its July Quarterly Average Sales Price (ASP) Medicare Part B drug pricing files and revisions to previous Quarterly Pricing Files.