Medicare compensation

March 24, 2006

I got this as part of an email from a MD. You might want to write or

call supporting this legislation.

In order to prevent further Medicare cut-backs I encourage all our

patients and relatives to call their United States Senators and ask

them to co-sponsor S 2340 - The Community Cancer Care Preservation Act -

introduced by Senator Arlen Specter. Many, many Senate offices have

called Senator Specter's office and are considering co-sponsoring the

bill.

Also, please continue calling your members of the House and ask them to

co-sponsor HR 4098 - the House version of the bill introduced by

ongressman Jim Ramstad.

Wording of bills below:

Community Cancer Care Preservation Act of 2006 (Introduced in Senate)

S 2340 IS

109th CONGRESS

2d Session

S . 2340

To amend title XVIII of the Social Security Act to preserve access to

community cancer care by Medicare beneficiaries.

IN THE SENATE OF THE UNITED STATES

February 28, 2006

Mr. SPECTER (for himself, Mr. COLEMAN, and Mr. ISAKSON) introduced the

following bill; which was read twice and referred to the Committee on

Finance

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A BILL

To amend title XVIII of the Social Security Act to preserve access to

community cancer care by Medicare beneficiaries.

Be it enacted by the Senate and House of Representatives of the United

States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the `Community Cancer Care

Preservation Act of 2006'.

( Table of Contents- The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Use of average sales price methodology.

Sec. 3. Improved payment for oncologist services.

Sec. 4. Quality measures for cancer care.

Sec. 5. Improved patient participation in clinical trials.

Sec. 6. CBO report.

SEC. 2. USE OF AVERAGE SALES PRICE METHODOLOGY.

(a) Findings- Congress finds that--

(1) in 2005, Medicare reimbursement for certain outpatient cancer drugs

was changed to reflect average sales price rather than average wholesale

price; and

(2) the average sales price methodology does not timely reflect changes

in manufacturer's prices for drugs.

( Adjustment to Average Sales Price Calculation- Section 1847A of the

Social Security Act (42 U.S.C. 1395w-3a) is amended--

(1) in subsection (, by adding at the end the following new paragraph:

`(6) RECONCILIATION- Payments made pursuant to this subsection are

subject to reconciliation to assure that such payments do not exceed or

fall short of the actual average sales price during any preceding

period. Such reconciliation shall be conducted on a quarterly basis and

the Secretary shall review all payments made to physicians under this

subsection in the preceding quarter and compare such payment to the

verified average sales price reported by the manufacturer under

subsection © for such quarter.'; and

(2) in subsection ©(3)--

(A) in the first sentence, by striking `prompt pay discounts,'; and

( in the second sentence, by inserting `other than prompt pay

discounts,' after `other price concessions,'.

SEC. 3. IMPROVED PAYMENT FOR ONCOLOGIST SERVICES.

(a) Findings- Congress finds that--

(1) in 2005, the Centers for Medicare & Medicaid Services implemented a

$300 million demonstration project to identify and assess certain

oncology services in an office-based oncology practice that positively

affect cancer outcomes in the Medicare population; and

(2) oncologists and cancer patients benefited from the demonstration

project.

( Continuation of Current Demonstration Project to Identify and Assess

Oncology Services That Positively Affect Cancer Outcomes-

(1) IN GENERAL- The existing demonstration project, developed by the

Secretary of Health and Human Services pursuant to the Secretary's

authority under sections 402(a)(1)( and 402(a)(2) of the Social

Security Amendments of 1967 and implemented in the Federal Register,

`Revisions to Payment Policies Under the Physician Fee Schedule for

Calendar Year 2005,' 69 Fed. Reg. 66,236 (November 15, 2004), for

purposes of identifying and assessing certain oncology services that

positively affect outcomes in the Medicare population, shall be extended

until December 31, 2006.

(2) IMPLEMENTATION- The Secretary shall continue to operate such project

in the same manner as originally implemented.

(3) FUNDING- Under the demonstration project over the duration of the

project, the Secretary shall apply the methodology and funding

consistent with that established for the existing project.

(4) REPORT- Not later than July 1, 2007, the Secretary shall submit to

Congress a report on the project, together with recommendations for such

legislation and administrative action as the Secretary determines to be

appropriate.

Social Security Act (42 U.S.C. 1395w-4©(2)) is amended--

(1) in subparagraph ((iv)--

(A) in subclause (II), by striking `and';

( in subclause (III), by striking the period and inserting `; and';

and

`(IV) subparagraph (K) insofar as it relates to a physician fee schedule

for 2006 shall not be taken into account in applying clause (ii)(II) for

drug administration services under the fee schedule for such year.'; and

(2) by adding at the end the following new subparagraph:

`(K) ADJUSTMENT IN PAYMENT RATES FOR OVERHEAD COSTS- In establishing the

physician fee schedule under subsection ( with respect to payments for

drug administration services furnished on or after January 1, 2006, and

in order to take into account overhead and related expenses, the

Secretary shall provide for an additional payment in an amount equal to

2 percent of the amount determined under section 1847A for the drug

administered.'.

SEC. 4. QUALITY MEASURES FOR CANCER CARE.

(a) Findings- Congress finds that--

(1) existing quality indicators relating to the quality of care

furnished to cancer patients in physician offices are inconsistent

across practice settings and are not based on uniform, evidence-based

and consistently applied standards; and

(2) physician reimbursement should reflect improvements in the quality

of care provided.

( Development of Quality Indicators- In collaboration with practicing

physicians, the Secretary of Health and Human Services shall develop

indicators for the evaluation of the quality of oncology services

provided in the physician office setting. Such indicators shall not be

implemented for any purpose unless the Secretary has provided for an

assessment of the proposed indicators by the physician community.

projects and demonstration projects to test such indicators as

appropriate.

SEC. 5. IMPROVED PATIENT PARTICIPATION IN CLINICAL TRIALS.

(a) Findings- Congress finds that--

(1) the current report of the President's Cancer Panel has documented

the increasing incidence and costs of cancer to the United States; and

(2) the current report of the President's Cancer Panel has identified

problems in translating research into effective cancer care.

( Strategic Plan for Improved Patient Participation-

(1) IN GENERAL- In collaboration with practicing physicians, the

Director of the National Cancer Institute shall develop a strategic plan

to increase the number of cancer patients who enroll in clinical trials.

(2) COMPONENTS OF PLAN- Such plan shall include components designed to--

(A) improve patient education regarding clinical trials;

( facilitate the clinical trial process; and

where treatment is provided.

Human Services shall submit to Congress a report on the strategic plan

under subsection ( together with recommendations for such legislation

and administrative action as the Secretary determines to be appropriate.

SEC. 6. CBO REPORT.

Not later than one year after the date of the enactment of this Act, the

Director of the Congressional Budget Office shall submit to Congress a

report that describes the impact of the provisions of the Medicare

Prescription Drug, Improvement, and Modernization Act of 2003 (Public

Law 108-173) as implemented on oncologists and other physicians who

provide cancer care and a comparison of such impact with the impact of

such law estimated by such Office before its enactment.

Community Cancer Care Preservation Act of 2005 (Introduced in House)

HR 4098 IH

109th CONGRESS

1st Session

H. R. 4098

To amend title XVIII of the Social Security Act to preserve access to

community cancer care by Medicare beneficiaries.

IN THE HOUSE OF REPRESENTATIVES

October 20, 2005

Mr. RAMSTAD introduced the following bill; which was referred to the

Committee on Energy and Commerce, and in addition to the Committee on

Ways and Means, for a period to be subsequently determined by the

Speaker, in each case for consideration of such provisions as fall

within the jurisdiction of the committee concerned

------------------------------------------------------------------------

--------

A BILL

To amend title XVIII of the Social Security Act to preserve access to

community cancer care by Medicare beneficiaries.

Be it enacted by the Senate and House of Representatives of the United

States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the `Community Cancer Care

Preservation Act of 2005'.