July 2008 Practice Update

Senate Passes H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008
On July 9, the U.S. Senate passed legislation H.R. 6331 to prevent the 10.6 percent reduction in physician fees scheduled to take effect on July 1, and provided a 1.1 percent increase in the conversion factor for calendar year 2009. For the first time since his surgery and treatment for cancer, Senator Edward Kennedy (D-MA) returned to the Senate to cast the needed 60th vote to prevent a filibuster and allow for the bill's passage.

Two weeks ago, the Senate was unable to pass the House-passed Medicare bill, which failed by a vote of 58 to 40. With Senator Kennedy's arrival to cast the 60th vote, nine Republicans cast their votes in favor of the bill, making the final vote 69 to 30. Senator McCain was the single Senator who did not cast a vote.

The bill now heads to President Bush who has said repeatedly that he will veto it because he objects to financing restoration of physician payment through cuts to Medicare managed care plans. It is unclear if the Republican Members of the House and Senate would cross the President and vote to override his veto, or if the President will veto given the strong votes in both the House and Senate. The extension of the current payment rate is due to expire on July 14. Legislation or a second administrative extension is needed to prevent the 10 percent payment reduction from taking place. While it is anticipated that eventually legislation will pass to prevent the reduction in fees, when it will occur is uncertain.

ASH thanks all members who participated in the Society's advocacy efforts and campaigns. We will continue to provide updates as new information becomes available.

For information about how Medicare claims are currently being paid, please visit Policy & Practice News section of the ASH Web site.

ASH Analysis of Medicare Physician Fee Schedule Proposed Rule
On July 7, the Centers for Medicare & Medicaid Services (CMS) published its proposed Medicare physician fee schedule for 2009 in the Federal Register. ASH has developed the following summary of the proposed rule and analysis of its impact on hematologists. ASH will be providing comments to CMS by the August 29 deadline. If you have any specific concerns or questions, please contact please contact ASH Senior Manager, Policy & Practice, Carol Schwartz at 202-776-0544.

CMS Adds Gold Standard, Inc., Clinical Pharmacology Compendium to List of Approved Compendia
CMS has added Gold Standard, Inc., Clinical Pharmacology to the list of approved compendia for determining medically accepted off-label uses of cancer drugs. For more information, vist the CMS Web site.

Medicare Provides New Information Concerning Inpatient Prospective Payment System Hospital and Long-Term Care Hospital Review and Measurement
CMS has provided the following new materials and information concerning the Inpatient Prospective Payment System Hospital and Long-Term Care Hospital Review and Measurement. For more information, visit the CMS Web site to view a fact sheet as well as a PowerPoint presentation.

Comments Due Next Month on J4 MAC Draft Local Coverage Determination
TrailBlazer Health Enterprises, the Medicare administrative contractors (MAC) in the Jurisdiction 4 region (J4) released a draft policy on Erythropoiesis Stimulating Agents (ESAs). The J4 region includes: Colorado, New Mexico, Oklahoma, and Texas.

The draft policy can be found on the TrailBlazer Web site and is open for public comment until August 11, 2008. ASH is currently analyzing the policy to make sure it is consistent with ASH's Model Policy for Local Medicare Carriers on MDS as well as addressing other specific concerns. Once prepared, these recommendations will be shared with the practice community. ASH will also submit written comments, but feedback from local physicians carries significant weight with local carriers and MACs.

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

ASH Comments on CMS' Proposal to Develop a Physician Compare Web Site
ASH sent comments in response to the Centers for Medicare and Medicaid Services' proposal to develop a physician compare Web site. Visit the ASH Web site to view the full letter.

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