May 2005 Practice Update

Capitol Hill Day Success
Thanks to all committee members who participated in the committee’s Capitol Hill Day.  Committee members visited 30 congressional offices, where they shared ASH’s interest about the proper valuation of Evaluation & Management (E/M) Codes during the RUC’s five-year review, urged support for embryonic stem cell research legislation, and requested that the Senate Special Committee on Aging conduct a hearing on anemia and the elderly. ASH staff is contacting each member of the committee who participated in the Capitol Hill Day with personalized follow-up.

Five-Year Review Survey
ASH, along with several other specialty societies, has agreed to survey the inpatient and outpatient consultation codes and the critical care codes as part of the five-year review of relative values. The objective of this review is to determine if a service is currently valued correctly or if the physician work may have increased or decreased since the code was last evaluated. Committee on Practice members will be contacted in the next several weeks to fill out a survey questionnaire on these codes.  We strongly urge you to participate.  After the surveys are completed, ASH will make recommendations to the Relative Value Updating Committee (RUC), which is a multi-specialty committee operating under the aegis of the AMA.  The RUC reviews and finalizes the recommendations and sends them to CMS for review and approval.  Relative value changes from this five-year review of the RBRVS will be implemented on January 1, 2007.  Please note: Your support and participation is critical to the success of this survey effort.  Thank you in advance for your participation.

Medicare Physician Reimbursement Legislation
Senators John Kyl (R-AZ) and Debbie Stabenow (D-MI) introduced legislation in the Senate (S. 1081) and Representatives Clay Shaw (R-FL) and Ben Cardin (D-MD) introduced legislation (H.R. 2356) on May 12 aimed at fixing the Sustainable Growth Rate (SGR).  The Centers for Medicare and Medicaid Services (CMS) informed the Medicare Payment Advisory Commission (MedPAC) that the update to the 2006 physician fee schedule is currently projected to be -4.3 percent.  The bill would: (i) set the Medicare physician payment update for 2006 at no less than 2.7 percent, and (ii) beginning in 2007, implement MedPAC's recommendation to replace the current SGR with updates based on inflation in physicians’ practice costs. However, as ASH discussed with congressional staff during the committee’s Capitol Hill Day, it is likely that any adjustment to the SGR would be tied to pay-for-performance initiatives.  It is also unclear if the Congress will take action on Medicare legislation this year.

Representative Hall Calls on CMS to Extend Cancer Care Demonstration Project
On May 4, 2005, Representative Ralph Hall (R-TX) introduced a congressional resolution to extend the CMS cancer care demonstration project beyond 2005. While grateful to CMS for establishing this program, ASH remains concerned about CMS’s decision to make Medicare beneficiaries responsible for a 20% copayment. As expressed in a letter to CMS last December, the Society believes that repeatedly subjecting cancer patients to the coinsurance during the course of their treatment will pose financial hardship to beneficiaries, especially those without supplemental coverage.

ASH continues to work with Congress to support adequate physician reimbursement for administering Part B drugs. The Society also is engaged through its Quality of Care Subcommittee and its Task Force on Pay-for-Performance in initiatives to enhance quality of care to the patients hematologists treat.

More information about the CMS cancer care demonstration project is available on the ASH Web site.

Pay-for-Performance Initiatives for Physicians
During its April meeting, the ASH Executive Committee recognized the heightened congressional involvement in pay-for-performance initiatives in Medicare and approved a recommendation that the Quality of Care Subcommittee help prepare the Society and its practicing members for Medicare pay-for-performance requirements.  Subsequently, the Committee on Practice created a special task force to devise formal criteria for hematology-related performance measures and to create with appropriate experts viable performance measures to be used by practicing hematologists.  The work of the task force will be reviewed by the Quality Subcommittee and shared with the full Committee on Practice.

Representation on the AMA Relative Value Updating Committee (RUC)
We are pleased to announce that David Regan, M.D., was appointed to serve on the RUC in the internal medicine rotating seat.  Dr. Regan was nominated by ASCO and ASH for this position.  He is the ASCO liaison to the ASH Committee on Practice.  Sam Silver, M.D., Ph.D., was named as Dr. Regan’s alternate.  Dr. Silver is Chair of the ASH Reimbursement Subcommittee and a member of both ASH and ASCO.  The committee continues to work with other cognitive specialty societies to expand the RUC composition to include a permanent hematology/oncology seat.  A copy of the ASH/ASCO request letter from the February RUC meeting can be viewed online. 

7th Annual Hematology/Oncology/SGO CAC Network Meeting
ASH is planning the 7th Annual Hematology/Oncology/SGO CAC Network Meeting scheduled for July 22-23 in Washington, DC.  Please contact mbecker@hematology.org as soon as possible if you have any issues you believe would be useful to add to the agenda for the meeting.

ASH Presents Symposium on Lymphoma and Myeloma in September
The September 2005 State-of-the-Art Symposium, “Lymphoma and Myeloma: Recent Advances in Biology and Therapy,” is designed for those interested in the latest advances in multiple myeloma and lymphomas, as well as the role of stem cell transplantation in their treatment.  Registration opened May 2.  Click here to find more information about the event.

If you have questions, or need more information about the items above, please contact ASH Director of Government Relations & Practice Mila Becker at mbecker@hematology.org or (202) 776-0544.