September 2007 Practice Update

Below is the latest information on the practice issues ASH has been following. We feel it is important to keep our membership well informed of ASH's practice-related activities, so we have decided to disseminate updates more widely throughout the ASH practice community. We would welcome any comments or feedback any of you may have. We strongly encourage you to share this message with your colleagues.

House-Senate Continue Work on Children's Health Bill and Medicare Physician Payment Legislation
The Children's Health and Medicare Protection Act (H.R. 3162), which the House passed on August 1, would reauthorize the State Children's Health Insurance Program (SCHIP) and also replace scheduled cuts in Medicare physician payments with two years of positive updates. The Senate passed legislation (H.R. 976) in August that focused solely on SCHIP. Senate Republicans had indicated that they would not support the increased SCHIP funding in the House bill ($50 billion vs. $35 billion) and plan to address Medicare physician payment cuts in separate legislation later this year. Meanwhile Senate Democratic leadership also strongly support advancing a SCHIP-only agreement that would be sent to the White House before the September 30 deadline for reauthorization of the program, although House Democrats have advocated for including Medicare provisions in the bill. As this Practice Update was going to press, congressional staff reported that an agreement to separate the Medicare provisions – including the physician payment update – had been reached and Medicare physician payment legislation will be taken up by the House and Senate in the coming weeks.

TAKE ACTION: All physicians are strongly encouraged to contact Congress to prevent the scheduled 10 percent cut in physician payment. Please visit the ASH Advocacy Center to join the ASH Grassroots Network.

ESA Update: ASH Requests Reopening of National Coverage Decision
ASH has requested that CMS reopen its recent National Coverage Decision (NCD) concerning erythropoiesis-stimulating agents (ESAs) due to the limitations on patients undergoing ESA therapy for non-renal uses. Specifically, ASH has urged CMS to allow coverage for the continued use of ESA therapy where the patient is brought to a hemoglobin level between 10 and 12g/dL in order to appropriately manage care. Currently, the NCD stops coverage once the hemoglobin has reached 10 g/dL. Based on recent conversations, CMS appears to be willing to reconsider its NCD on ESAs once it receives additional information from the Society. For more information, please see ASH's news update on the NCD for coverage of ESAs.

ASH and AMA Conducting Physician Practice Information (PPI) Survey
For the first time in nearly a decade, ASH, the American Medical Association (AMA), and more than 70 other medical specialty societies, have worked together to coordinate a comprehensive multi-specialty survey of America's physician practices during 2007. The purpose of the survey is to collect up-to-date information on physician practice characteristics in order to positively influence national decision makers while further developing and refining AMA and ASH policy.

The unique aspect of the project is that it explores both the clinical and business side of medical practice. It is important for the nation's policy-makers to learn what is truly involved in running a practice that can provide patients with expert care but is able to do so in a sustainable way. The data obtained will be an important source of information for the AMA and ASH. It will represent practice concerns to national policy-makers that will lead to policy initiatives that not only help in the short-term but will allow future generations of doctors to continue providing superior care to their patients.

There is a small section in this study pertaining to practice expenses and the amounts that are attributable to you. This is a vital part of the research and we need to have accurate and complete data. This information remains confidential; Gallup does not identify any individuals or entities participating in this research to any of the participating organizations.

The Gallup Organization has been retained to conduct the PPI survey among a representative sample of practices in each of the participating specialties. The PPI survey is an important and necessary vehicle for positive change. Please watch for this survey in the coming weeks and do your part in completing it in a thorough and accurate manner if randomly selected to represent our specialty.

ASH Comments on Hospital Outpatient Prospective Payment System (HOPPS) Rule
ASH submitted comments on the HOPPs rule. ASH comments have focused on bone marrow and stem cell processing services and on radioimmunotherapy agents. For more information, please see the HOPPs section of the CMS Web site.

ASH Comments on Public Release of Medically Unlikely Edits (MUEs)
ASH recently submitted comments to the National Correct Coding Initiative on the public release of MUEs.

CMS Posts Responses to Frequently Asked Questions about Tamper-Resistant Prescription Pad Rules
As a follow-up to the guidance it published on August 17, the Centers for Medicare and Medicaid Services (CMS) have posted an FAQ document in response to questions about a new law that restricts Medicaid pharmaceutical reimbursement to prescriptions executed on tamper-resistant pads.

CMS Hosts National Provider Conference Call on PQRI
CMS will host a national provider conference call on the 2007 Physician Quality Reporting Initiative (PQRI). This toll-free call will take place Wednesday, September 26, 2007, from 1:30 p.m. to 3:30 p.m. EDT. For more information and a link to register for the call, please see ASH's news update on the national provider conference call.

Help Us to Improve the ASH Image Bank
The ASH Image Bank is an incredible educational resource that is designed to further the understanding of hematology by sharing images of different hematologic conditions. The Image Bank contains over 500 images that are searchable by title, author, category, and date. This resource is free of charge and can be accessed online through the Hematology Library. We need your help to ensure that this tool is up-to-date and useful for all who need it. If you have an interesting image, please consider submitting it to the ASH Education and Training Department at cme@hematology.org.

Register for the 2007 ASH Annual Meeting
ASH is gearing up for the 2007 ASH Annual Meeting, taking place from December 8-11 in Atlanta, GA. The ASH annual meeting provides an unparalleled opportunity for hematologists and professionals in hematology to network, gain valuable clinical information, and learn about the latest research in the field. Visit the annual meeting section of the ASH Web site, to explore the scheduled special lectures, special interest sessions, Education Program, Education Spotlight Sessions, Scientific Program, and much more. Or register today.