Medical Oncology Association of Southern California
P.O. Box 161
Upland, CA 91785
Phone: (909) 985-9061
Fax: (909) 985-8581
email: moasc@moasc.org

MOASC would like to recognize and thank the following sponsors for their continued support of MOASC:

COA Recommendations on Medicare Demonstration Project

The Community Oncology Alliance (COA) believes strongly that the $300 million Medicare demonstration project be extended through 2006 and be funded at the current level.  The demonstration project has provided payment for important services that were subsidized by drug payment under the old Medicare reimbursement system.  It is the type of quality, pay-for-performance initiatives that the Centers for Medicare and Medicaid Services (CMS) is promoting.  

Additionally, the demonstration project has provided important funding for services not reimbursed (such as treatment planning) under the new Medicare reimbursement system. The extension of the demonstration project is not a permanent solution to appropriate Medicare reimbursement for cancer care but is a vital bridge in correctly reforming Medicare.  The Medicare system is not correct until ASP-based drug reimbursement is fixed and services, such as treatment planning and pharmacy, are paid for appropriately.

Attached are very specific recommendations that COA has prepared.  We met with CMS yesterday and reviewed these.  We are providing these to Members of Congress.  COA is recommending that CMS collect the same data on pain, fatigue, and nausea but that community cancer clinics be provided with more precise instructions on data collection. Additionally, we recommend that the assessments be done on all patients, not just incident to chemotherapy and CMS consider adding anxiety/depression as a symptom. We have provided justification and references supporting our position and suggestions for pilot projects collecting other data.  As you will see from the attached, we are very concerned that additional data elements such as staging be piloted first before CMS attempts to collect this nationally.  

There has been considerable support in the Congress for extending the demonstration project, as evidenced by the House and Senate letters to the President.  

Late last night (07/27/05) the Hall resolution on extending the demonstration project was offered as an amendment to the House version of the energy bill and passed.  The Energy bill will now go to conference committee to reconcile differing House and Senate versions.  What this means is simply that there will be a resolution on the sentiment of the Congress that the demonstration be extended though at least 2006.  However, this piece of the legislation needs to survive the reconciliation conference and would not be law but would be a resolution.  

We again want to underscore that the demonstration project needs to be extended at the current level of funding.