What's New (visit http://www.medicarenhic.com/whats_new/whats_new.shtml)

• CMS has issued a press release about Hurricane Katrina .
• CMS has issued clarification on the Termination of HIPPA Contingency Plan (JSM 05512)
• CMS revised the Medlearn Matters Article on the October Update to the 2005 Medicare Physician Fee Schedule Database (CR 4031).
• Learn about Financial Liability for Services Subject to Home Health Consolidated Billing (CR 3948).
• CMS has revised the article on the October 2005 quarterly average sales price (ASP) Medicare Part B drug pricing file to include the revisions for the July and April 2005 quarterly ASP. (CR 3992)
• CMS has developed Public Service Announcements (PSAs) for the provider community to increase awareness of the new prescription drug coverage and the resources available to assist people with Medicare. There are two versions of the PSAs---the only difference between the two is the graphics and orientation (horizontal vs. vertical). The PSAs are posted on http://www.cms.hhs.gov/medlearn/drugcoverage.asp, under the heading, "Basic Information for Health Care Professionals."
• CMS is pleased to announce the availability of Determining a Medicare Beneficiary's Eligibility for Medicare Preventive Services. This guide shall be used to educate providers in accordance with the provider education instructions in CR 4011 and is available on the MedLearn Network's Preventive Services Educational Resource Web Guide page under the Provider Education header. This page can be viewed at: http://www.cms.hhs.gov/medlearn/preventiveservices.asp

CA Updates (visit http://www.medicarenhic.com/cal_prov/updates.shtml)

• New Educational Articles have been posted:  ICD-9-CM Changes - Effective Oct. 1, 2005
• The October 2005 changes to the Fee Schedule are posted.
• CMS has been experiencing intermittent technical difficulties with one of the servers for the Local Coverage Determination website. If you need to check the Local Coverage Determinations on the Medicare Coverage Database, try using the following links:
  http://www3.cms.hhs.gov/mcd/search.asp If you have problems, keep trying.
• The Specialty pages have been updated.

SE0555 - Medicare's Implementation of the National Provider Identifier (NPI): The Second in the Series of Special Edition  Medlearn Matters Articles on NPI-Related Activities
http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/SE0555.pdf

MM3992 - October 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing File and Revisions to April 2005 Quarterly ASP Medicare Part B Pricing File, Effective October 1, 2005 Revised:  9/19/2005
http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3992.pdf

ASCO Comments to CMS on the CAP Interim Final Rule 
ASCO submitted comments on CMS's Competitive Acquisition Program (CAP) for Medicare Part B drugs and biologicals.  CMS has temporarily delayed CAP program implementation and now expects the program to begin by July 1, 2006.



Legislative Update: House Resolution 261
Over the next few weeks, Congressional leaders will continue to focus their efforts on providing relief to states in the Gulf Coast region and the Supreme Court Confirmation Hearings.

ASCO is continuing to work with Representative Ralph Hall (R-TX) and other supporters in Congress to advance House Resolution 261, which urges CMS to continue the oncology demonstration project in 2006. We will continue to provide updates on timing and legislative action. ASCO's Policy Team will continue to work closely with Congress and CMS in the coming weeks and months to ensure that extending the CMS oncology demonstration project is a priority.

Contact ASCO's Cancer Policy & Clinical Affairs Department at 703-299-1050, or email publicpolicy@asco.org with any questions.



House Health Subcommittee Chairs Request Investigation of IVIG Pricing and Supply
Representative Nancy Johnson (R-CT), Chair of the House Ways & Means Subcommittee on Health and Representative Nathan Deal (R-GA), Chair of the House Energy & Commerce Subcommittee on Health have written a letter to Department of Health and Human Services Secretary Michael Leavitt requesting that supplies and pricing for intravenous immune globulin (IVIG) therapy be investigated by the Office of the Inspector General (OIG).  Congressional staff have been working on the Committees’ behalf to determine whether costs incurred by physician offices that provide the therapy are higher than the Medicare reimbursement rate, which could have an adverse effect on patient access to the drug.  Reps. Johnson and Deal note that patients receiving IVIG are in many instances being referred to the hospital, where the drug is being paid as a percentage of AWP until 2006, when the ASP system will be implemented for hospital payments as well.  The letter requests that the OIG examine supply of IVIG in response to reports of shortages (not connected to Medicare payment rates), though manufacturers have stated that a one-month supply is available.

ASCO will continue to monitor Medicare reimbursement for IVIG and other drugs for which members have reported that Medicare payments are below cost. You are encouraged to share information about inadequate drug reimbursement rates affecting your practice with ASCO by e-mailing publicpolicy@asco.org.