Ensure the Continued Solvency of Community Oncology -
Report by Mariana S-B Lamb, M.S., MOASC Exec, Director
Original Message posted to the MOASC Listserv, 11/01/05:
I apologize, in advance, for the length of this note to you.
I have returned from Washington, DC where I, and a California contingency comprising of Dr. Linda Bosserman, her oncology nurse Hope Gutierrez, and her two oncology N.P.'s Melissa Scalia and Traci Young; Orange County oncology practice executive Charles Denny and OTN President, John Amos, lead by former Congressman Harold Ford, Sr., met with the health aides of Senators Feinstein and Boxer and the health aides of nine California Representatives. First, I want to thank these MOASC members for the time they took out of their very busy lives to communicate the specific needs of California oncology to our Washington senators and representatives. Our message was succinct, "preserve the community practice of oncology."
Following are some observations of our meetings of last week, and a message from Steve Coplon (COA co-Exec. Dir.) on what can be done by all MOASC members to ensure continued solvency of community oncology care.
1) The Community Oncology Alliance (COA) had drafted a house bill (H.R 4098) which was introduced by Rep. Jim Ramstad of Minnesota. Rep. Ramstad sits on the House Ways and Means subcommittee on Health. The bill, known as the "Community Cancer Care Preservation Act of 2005" has five specific "asks" of congress. 1) Re-formulate the ASP methodology of payments for drugs to physicians; 2) Improve payment for oncologist services which includes the extension of the existing demonstration project; 3) Improved and consistent standards in implementing a meaningful pay-for-performance reimbursement model; 4) Improved patient participation in clinical trials; and 5) directs the Congressional Budget Office (CBO) to rescore the provisions of the MMA of 2003 to compare the impact of its implementation on oncologists and other physicians who provide cancer care with the estimates provided prior to the enactment of the MMA 2003. We also asked the house representatives to co-sign this bill. We asked the senators to support such a bill should one be introduced in the senate. (please see the MOASC website to read about H.R.4098).
- Senator Feinstein's health aide, Tamar Magarik, is requesting specific underwater drug information, on behalf of the Senator. What are the names of the drugs and what is the variance between the purchase price of the drugs and the cost to the practice to deliver that drug? Sen. Feinstein is interested in the access to care difficulties Medicare beneficiaries are experiencing in California (i.e., hospital outpatient departments not accepting Medicare patients when referred by the oncologist for outpatient chemotherapy, late night or 2am scheduling of blood transfusions by the hospital). Co-pays are a concern for the senator. Are Medicare beneficiaries paying more in co-pays under the demonstration project than what they paid under the AWP drug payment system? Sen. Feinstein would consider supporting a senate companion bill of HR 4098.
- Senator Boxer's legislative assistant, Lynn Dondis, was quite receptive and supportive of community oncology. The Senator would consider a sign-on letter once a senate companion bill to HR 4098 is introduced.
- Rep. Bill Thomas (R-Bakersfield, Taft, Tehachapi, Ridgecrest, Paso Robles, Arroyo Grande, and Lancaster) is the Chair of House Ways & Means Committee. We had a productive discussion with the House Ways & Means Health Subcommittee Staff Director, Joel White, and professional staff members Madeleine Smith, Ph.D. and Kathleen Weldon. Rep. Thomas is requesting specific underwater drug information, as does Sen. Feinstein. What are the names of the drugs and what is the variance between the purchase price of the drugs and the cost to the practice to deliver that drug? What differentiates the delivery of community oncology care from other specialties, thereby requiring oncologists to be reimbursed more than an internal medicine specialist? Rep. Thomas is opposed to the continuation of the existing demonstration project based upon information provided by the OIG. When data is provided to Rep. Thomas, there may be reconsideration of this current position. (please see MOASC website for COA's response to the OIG report).
- Rep. Hilda Solis (D-East LA /San Gabriel Valley) Legislative Director, Carina Armenta indicated interest in HR 4098 . Rep. Solis is proposing an exemption of pediatric oncology drugs from the Budget Reconciliation Bill which will cost-share prescription drugs.
The following representatives were also visited by all or one of us. The general consensus was positive but all were in need of answers to the same questions as stated above by Sen. Feinstein and Rep Thomas.
- Rep. Xavier Becerra (D-Los Angeles); Rep. Ken Calvert (R-San Clemente,Norco,Corona, Riverside) ;Rep. Lois Capps (D-Santa Barbara County, San Luis Obispo County, and Ventura County); Rep. David Dreier (R- La Crescenta, Montrose, La Canada Flintridge, Altadena,Pasadena, San Marino, Sierra Madre, Arcadia, Monrovia, Bradbury,Glendora, La Verne, San Dimas and Claremont, Walnut, Upland, Montclair and Rancho Cucamonga, Wrightwood); Rep.Tom Lantos (D-San Mateo, San Francisco); Rep. Grace Napolitano (D-Norwalk, Pomona, Santa Fe Springs, the City of Industry, Montebello, Pico Rivera, Avocado Heights, La Puente, Hacienda Heights, West Puente Valley and parts of East Los Angeles, Whittier, Rowland Heights, South San Gabriel, Valinda) and Rep. Pete Stark (D- Alameda, Cherryland, Fremont, Hayward, Newark, San Leandro, San Lorenzo, Sunol, Union City, and parts of Oakland and Pleasanton)
Please read the following from Steve and get involved with your own representatives. Please let the MOASC office know of your individual progress.
Thank you,
Mariana
