New Medicare Legislation Revises Reimbursement Formula for Chemotherapy

Last December, President Bush signed into law new Medicare legislation that creates a prescription drug benefit for Medicare beneficiaries. The legislation also contains revisions to the reimbursement formula for chemotherapy. For 2004, the payment will be based on 85 percent of the average wholesale price (AWP) for most drugs. In 2005 and beyond, payment will generally be based on 106 percent of the actual manufacturer's sales price (ASP).

ASH is deeply concerned about the financial impact the reimbursement changes will have on hematology/oncology practices. Although the legislation provides increases in practice expense, beginning in 2005 it appears that Medicare payment for chemotherapy agents and other drugs will be dramatically reduced.

There are still many unknowns regarding how the ASP level will be determined and what this change might mean for hematologists. ASH will be collecting data from members who are hematologists/oncologists practicing in a community setting to understand how much they are paying for some commonly used drugs and how they are purchasing drugs. This will help the Society assess the impact of the legislation. In addition, these data will help the Society analyze the validity of the ASP rates promulgated by the Centers for Medicare and Medicaid Services (CMS). Importantly, these data will also help the Society fight for improvements in the reimbursement formula.

For more details and updates on the Medicare legislation and its impact on hematologists, please visit the ASH Web site.

ASH Prepares to Launch “Find a Hematologist”

In keeping with ASH's mission to promote first-rate clinical care for hematology patients, ASH will soon be launching a new publicly-accessible directory of practitioner members at www.findahematologist.org.

The new Find a Hematologist feature will allow patients to search for a hematologist in their area. Users will be able to enter their city, state, or country and select certain specialties and clinical interests, and will then be provided with office contact information for the ASH members meeting their search criteria.

ASH members who are currently accepting new patients are encouraged to register for this service by visiting the members-only section of the ASH Web site beginning in March. The link for this service will be sent out in an upcoming issue of ASH NewsLink. Alternatively, members can complete the card that was distributed to all attendees at the annual meeting and return it to ASH. You will be able to opt-out at any time.