ASH Office of Government Relations & Practice Implements 2004 Agenda, Steps Up “E-Advocacy” Efforts

The ASH Office of Government Relations & Practice addresses legislative and regulatory issues that have an impact on the practice, research, education, and training of hematologists. ASH staff advocates on behalf of hematologists before Congress, federal agencies such as the Centers for Medicare & Medicaid Services (CMS), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the Centers for Disease Control & Prevention (CDC). In addition, the ASH Government Relations staff coordinates activities with the appropriate public, patient, and professional organizations, and relevant ASH Committees on issues of importance to hematology.

In 2004, ASH will be pursuing an expanded and intensified advocacy agenda that includes the following issues: improving Medicare reimbursement and developing strategies to increase payment for cognitive services; increasing federal funding for the NIH; monitoring the status of all stem cell-related legislation; and preventing use of counterfeit drugs. In addition, ASH plans to enhance its electronic advocacy efforts — that is, increasing participation in the ASH Grassroots Network by developing effective ways for ASH members to contact their Members of Congress with clear and timely messages through e-mail and the ASH Web site. In early 2004, ASH hopes to launch a new Government Relations Web site so that members can more easily find background information on policy issues that affect the hematology community and become more actively engaged in the legislative and regulatory process.

For more information about pending legislative or regulative issues of importance to hematology, visit the ASH Web site, or contact the ASH Government Relations & Practice Office at 202-776-0544.

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ASH Succeeds in Increasing 2004 Hospital Outpatient Rate for Bone Marrow Harvesting

The Centers for Medicare & Medicaid Services (CMS) is substantially increasing the payment for bone marrow harvesting and modestly increasing the payment for bone marrow/stem cell transplants as a result of ASH's comments on the proposed changes to the hospital outpatient rates for 2004.

The CMS correction notice, published December 31, 2003, in the Federal Register, revealed that ASH was the only commenter urging the Agency to increase payment for these codes. This underscores the influence a single commenter can have on the rulemaking process and the role of ASH in achieving this increase.

Under the leadership of the Committee on Practice, last October ASH wrote to CMS about the proposed payment rate assigned to APC 123, Bone Marrow Harvesting/Stem Cell Transplant. This APC is comprised of 3 CPT codes: Code 38230, bone marrow harvesting for transplantation; Code 38240, bone marrow or blood-derived peripheral stem cell transplantation, allogenic; and Code 38241, bone marrow or blood-derived peripheral stem cell transplantation, autologous. ASH argued that the proposed payment rate of $217.57 represented a substantial reduction from the current rate of $334.02 and grossly inadequate for these services. ASH believed that a major cause for this inaccurate assessment was that CMS was working with very low volume data – a total of 71 claims for all 3 codes. In the comment letter, ASH stressed that claims data appeared to be based on flawed claims and illustrated why the costs in performing bone marrow harvesting are more similar to costs involved in performing more expensive surgical procedures.

As a result, in its correction notice of the rule published December 31, 2003, CMS agreed that the costs involved in performing bone marrow harvesting are more expensive than originally proposed and moved the CPT Code 38240 to APC 0111 with a payment rate of $718.67. Although CMS decided to keep the other two codes in the APC 123, their payment rate will increase by $47.01 (from $288.53 to $335.54) above the rate state in the November 7, 2003 final rule.

A complete copy of ASH's comments to CMS concerning the proposed changes to the 2004 hospital outpatient rates can be found on the ASH Web site.

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News Headlines from Washington

CMS Administrator Tom Scully Resigns
The Centers for Medicare & Medicaid Services (CMS) Administrator Tom Scully resigned from the Agency effective December 15, following three years at the helm of the nation's second and third-largest domestic programs, Medicare and Medicaid. Scully became the ninth administrator of the agency formerly known as the Health Care Financing Administration on March 22, 2001. He led an intensive effort to improve the responsiveness of the agency, with a new name adopted from suggestions made by agency employees. He also expanded efforts to inject quality measurement into the agency's programs. Most notably, however, he led the effort to revise the reimbursement formula for chemotherapy and other agents. Scully did not immediately identify future plans. The Administration had not named an acting administrator prior to the deadline for The Hematologist.

Postal Stamp to Commemorate Sickle Cell
In continuation of its tradition to raise public awareness of health and social issues, the U.S. Postal Service will issue a new Sickle Cell Disease Commemorative Stamp for release this summer. This stamp is meant to convey the importance of early testing and will feature a mother holding her baby. An inscription will read “Test for Sickle Cell.”

Division of Hereditary Blood Disorders Established at the Centers for Disease Control & Prevention (CDC)
Last October, the Hereditary Blood Disorders (HBD) Division joined the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the CDC. Previously, HBD had been a part of the CDC's Division of AIDS, STD, and TB Laboratory Research (DASTLR) since 1995. A focus of the HBD division's work is to prevent and reduce complications experienced by children and adults with certain hereditary bleeding and clotting disorders, including thrombophilia and thalassemia, hemophilia, and von Willebrand disease. Through HBD, CDC supports and collaborates with a network of 135 treatment centers throughout the United States that provide multi-disciplinary prevention services, education, and support to 24,000 patients with bleeding and clotting disorders. The ASH Subcommittee on Quality of Care has begun working with HBD to find opportunities for collaboration.

New Grant Opportunities Available
New NIH Grant Opportunities in Myelodysplasia and Myeloproliferative Disorders Research are available. Please see the ASH Web site for more information and links to these NIH grants. The Government Affairs section of the ASH Web site will begin to regularly feature new grant opportunities for hematologic research.