Web site: www.usoncology.com
About US Oncology
US Oncology, Inc., headquartered in The Woodlands, Texas, works closely with physicians, payers, biotechnology, pharmaceutical and medical equipment manufacturers, to identify and deliver innovative services that enhance patient access to advanced cancer care. US Oncology supports one of the nation's foremost cancer treatment and research networks, accelerating the availability and use of evidence-based medicine and shared best practices.
US Oncology uses its expertise to support every aspect of the cancer care delivery system—from drug development to distribution and outcomes measurement—enabling the company to help increase the efficiency and safety of cancer care. According to the company's last quarterly earnings report, US Oncology is affiliated with 1,310 physicians operating in 493 locations, including 98 radiation oncology facilities in 39 states. For more information, visit the company's Web site, www.usoncology.com.
News and Items of Interest
US Oncology Applauds CMS Decision to Expand Coverage of PET
US Oncology applauds the decision on April 6, 2009 by the Centers for Medicare and Medicaid Services (CMS) to expand coverage of positron emission tomography (PET) scans in the treatment strategy of patients with cancer. US Oncology has been working closely with CMS as a major participant in a comprehensive study known as the National Oncologic PET Registry (NOPR), which produced compelling clinical evidence of the effectiveness of PET for cancer management and treatment.
US Oncology participated directly in the NOPR study that was initiated by CMS in 2006 to track the utility of PET in patients with cancer. The analysis of data from more than 41,000 patients was published in the Journal of Clinical Oncology and Journal of Nuclear Medicine, and both studies demonstrated that the use of PET scanning led to an intended change in cancer management in more than one of three patients.
The nine currently covered cancers (breast, cervix, colorectal, esophageal, head and neck, lymphoma, melanoma, non-small cell lung and thyroid) have all been expanded to cover the subsequent treatment strategy in addition to initial diagnosis. Additionally, CMS is now expanding coverage to include ovarian cancer and myeloma, making a total of eleven indications now covered for both the initial diagnosis and subsequent treatment strategy. For all other cancers, PET coverage for subsequent treatment strategy evaluation requires participation in an approved Coverage with Evidence Development (CED) program, such as a modified NOPR.
This action by CMS will increase access to these crucial scans for all Medicare and Medicaid beneficiaries. The decision to expand coverage of PET scans for cancer patients recognizes the importance of this tool for diagnosing, staging, restaging and monitoring treatment for cancer. The decision will save patients from having to pay out-of-pocket for these scans and will increase the likelihood that private insurers will begin follow CMS' lead with this important coverage for beneficiaries.
US Oncology applauds the decision by CMS to expand coverage of PET to Medicare and Medicaid beneficiaries and looks forward to continuing to work with CMS to ensure that all patients have access to the essential new technologies utilized in the modern fight against cancer.
Click here to read US Oncology comments submitted to CMS earlier this year.
Community Oncology Unifies in Support of Representative Green, Whitfield Bipartisan ASP Prompt Pay Discount Legislation
Legislation Would Better Align ASP Drug Reimbursement with Actual Cost
On March 9, 2009, Representatives Gene Green (D-TX) and Ed Whitfield (R-KY), senior members of the House Energy & Commerce Committee, introduced HR 1392, a bill to change the Average Sales Price (ASP) methodology used by Medicare to set prices for Part B drugs and biologicals to better align drug reimbursement with actual cost. Joining the Congressmen in this bipartisan effort are Representatives Mike Ross (D-AR), Ralph Hall (R-TX), Dianna DeGette (D-CO), Mike Rogers (R-MI), Ed Towns (D-NY), Betty Sutton (D-OH), Bart Gordon (D-TN), and Lee Terry (R-NE).
In November of 2008 with an additional communication delivered in March of 2009 the community oncology groups sent a joint letter to the U.S. House and Senate leadership strongly supporting efforts to remove the prompt pay discount from the calculation of ASP. This letter, signed by ACCC, Amerisource Bergen, COA, Curascript Specialty Distribution, HDMA, Health Coalition, Inc., McKesson Specialty Care Solutions, SBDA, UPMC Cancer Centers and US Oncology, was a strong signal that community oncology was unified in support of this ASP reform effort.
Drug manufacturers are currently required to net out prompt pay discounts paid to wholesale distributors before reporting ASP figures to the Centers for Medicare and Medicaid Services (CMS), even though the wholesaler prompt pay discount is not passed along to physicians. Physician drug reimbursements are lowered by approximately two percent by this provision in the ASP calculation, which is the customary amount of the wholesale distributor prompt pay discount.
HR 1392 clarifies this statute by removing "customary prompt pay discounts extended to wholesalers" from the list of price concessions that reduce ASP. The legislation also conforms prompt pay discount treatment in the ASP methodology to the Average Manufacturer Price (AMP) methodology used to set reimbursement for pharmacies in the Medicaid program.
US Oncology strongly endorses HR 1392 and looks forward to working with Reps. Green, Whitfield, and other champions of community cancer care to move this important legislation forward in the 110th Congress.
Click here to find your Members of Congress and ask them to co-sponsor HR 1392.
Click here to read HR 1392.
Click here to read a Dear Colleague letter in support of HR 1392.
Click here to read a letter of support sent to House leadership.
Senators Kennedy and Hutchison Introduce the 21st Century Cancer ALERT Act of 2009
On March 26, 2009, Senators Edward M. Kennedy (D-MA) and Kay Bailey Hutchison (R-TX) introduced the “21st Century Access to Life-Saving Early detection, Research and Treatment Cancer (ALERT) Act of 2009”, new legislation that aims to enhance cancer prevention, detection, research and treatment. This initiative includes provisions important to the oncology community including language that would expand coverage for cancer patients involved in clinical trials, incentivize the use of cancer care planning services, and work to determine the depth of the nationwide oncology workforce shortages.
This legislation would implement improvements in the coverage of cancer care services by codifying current Medicare policy to require reimbursement for routine care while patients are enrolled in clinical trials. The bill also includes a Medicare demonstration project to evaluate the cost, effectiveness, and potential savings to Medicare of reimbursing providers for comprehensive cancer care planning services. With respect to those covered under employer-sponsored private insurance, the bill would require self-insured health plans governed under ERISA to continue to provide coverage of routine care regardless of whether a cancer patient enrolls in a clinical trial.
This legislation also includes a provisions designed to modernize cancer research at National Cancer Institute (NCI), including an effort to coordinate their work with the National Cancer Program. The bill aims to improve access to cancer research with improved resources for research being conducted on cancers with low incidence and low survival rates. It would also establish a grant program for states to further implement cancer screening programs including biomarker discovery techniques, while giving states expanded options for covering cancer care for low-income individuals.
US Oncology applauds the leadership of Senators Kennedy and Hutchison and looks forward to continuing to work with them and other Congressional leaders to advance cancer care in America.
Click here to find a section-by-section summary of the legislation.
Click here to read a press release and op-ed from the offices of Sens. Kennedy and Hutchison.
Click here to read the draft text of this legislation.