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Home > Mediaroom > Press Releases > 2006 > Association of Community Cancer Centers Comments on 2007 Medicare Final Hospital Outpatient Department Rule

Lori Gardner, Senior Director
Communications & Marketing
301.984.9496 ext. 226

ACCC News Release

For Immediate Release: November 17, 2006

Association of Community Cancer Centers Comments on 2007 Medicare Final Hospital Outpatient Department Rule

ASP +6 Percent, Added Infusion Codes “Positive”, Lack of Payments for Pharmacy Services “Of Concern”

ROCKVILLE, Md.—The Association of Community Cancer Centers (ACCC) supports the decision of the Centers for Medicare and Medicaid Services (CMS) to keep payment for many separately paid oncology drugs at average sales price (ASP) plus 6 percent in 2007, and not to reduce payment to ASP plus 5 percent as CMS had proposed. In its comments to CMS, ACCC indicated that such a reduction would not be adequate to reimburse hospitals for both the costs of acquiring and preparing drugs for administration. ACCC had urged CMS to recalculate its payment rate and set rates at no less than ASP plus 6 percent in its final rule. That rule, Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2007 Payment Rates, was released Nov. 1, 2006.

“ACCC worked very hard with Congress and with CMS to keep 2007 drug reimbursement no lower than the 2006 levels,” said ACCC Executive Director Christian Downs, JD, MHA. “By keeping the payment rate at ASP plus 6 percent, CMS has chosen to protect cancer patients’ access to quality cancer care in the most appropriate setting.”

Still, ACCC is concerned that CMS has chosen not to reimburse hospitals for their pharmacy acquisition and handling costs. In its final rule, CMS stated that pharmacy handling costs are “included in hospitals’ charges for drugs.”  ACCC disagrees and urges CMS to continue to work with stakeholders to study these costs.

For 2007, CMS will implement three significant changes to payment policies for drug administration services. First, CMS will make separate payment for second and subsequent hours of drug administration services. Up to now, CMS has packaged payment for additional hours into payment for the first hour. Second, CMS has organized the drug administration codes into new ambulatory payment classifications (APCs) with new payment rates. Although payments for the first hour administration codes have been reduced, payments for administrations lasting two hours or longer will be increased. Third, CMS will use all of the Current Procedural Terminology (CPT) codes for drug administration instead of the current mix of CPT codes and C-codes.

ACCC is undertaking a detailed analysis of these and other recent changes to Medicare payment policies, including payment changes to imaging services, and will report to its membership as to the significance and possible effects on patient access to quality cancer care. ACCC continues to advocate for adequate reimbursement that will help to protect beneficiary access to care by maintaining aggregate Medicare hospital outpatient payments for drugs and biologicals.

About the Association of Community Cancer Centers
The Association of Community Cancer Centers (ACCC) is the leading advocacy and education organization for the multidisciplinary cancer care team. More than 23,000 cancer care professionals from over 2,000 hospitals and practices nationwide are affiliated with ACCC. It is estimated that 65 percent of the nation's cancer patients are treated by a member of ACCC. Providing a national forum for addressing issues that affect community cancer programs, ACCC is recognized as the premier provider of resources for the entire oncology care team. Our members include medical and radiation oncologists, surgeons, cancer program administrators and medical directors, senior hospital executives, practice managers, pharmacists, oncology nurses, radiation therapists, social workers, and cancer program data managers. For more information, visit ACCC's website at Follow us on Facebook, Twitter, LinkedIn, and read our blog, ACCCBuzz.

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