NewsLine 2010

Message from the President:
Shamoon Ahmad, MD, FACP

NOS Conferences and the Multidisciplinary
Treatment of Cancer

Shamoon Ahmad Most state societies are accustomed to providing educational programs on specific disease sites, such as breast cancer, lung cancer, or hematological malignancies. Few, however, are as adept as the Nevada Oncology Society in presenting multidimensional, multidisciplinary approaches from a variety of specialty physicians. In 2008, the Las Vegas conference looked at head and neck cancer from different vantage points. Last year’s conference in Las Vegas focused on various means of treating prostate cancer, and the fall 2010 conference in Reno included two vastly different presentations on breast cancer.

The upcoming 2010 NOS Membership Conference at the Four Seasons Hotel on Thursday, April 29, has the same mark of excellence as the conferences of the past! The Conference theme is "Making the Pieces Fit: A Team Approach to Thyroid Cancer."

A great program is planned with presentations by Drs. Robert Wang and Lubna Ahmad on the surgical and endocrinology perspectives of thyroid cancer, respectively. A discussion will then take place among the two presenters and the panelists: Dr. Shamoon Ahmad (medical oncologist), Dr. S. Robert Hurwitz (diagnostic radiologist), and Dr. Anita Pomerantz (radiation oncologist).

Although thyroid cancer is not particularly common, the incidence of it has increased dramatically over the past two decades. Among women, it is responsible for the fastest rising number of new cases. The subject is unique, the venue is different, but the excellent quality of the program is the same. Visit the NOS website for registration information. Plan NOW to attend this Conference.

Healthcare Policy: No Rest for the Weary
by Matthew Farber, MA
Director, Provider Economics & Public Policy, ACCC

Healthcare Policy This last year has certainly been an interesting and busy one for healthcare policy. On the legislative front, a great deal of talking and negotiating took place, and we finally have a new healthcare reform law in place. On the regulatory front, it also was a very busy time with even more negotiating taking place. On that front, a final rule was released; unfortunately, with some bad news for oncologists.

Healthcare Reform
On March 21, 2010, the House of Representatives passed a landmark healthcare bill that seeks to extend health coverage to most Americans. An estimated 24 million people who lack access to affordable coverage through the workplace will be eligible for tax credits to buy insurance on new state-based exchanges. Medicaid, the federal-state program that provides health insurance to the poor and disabled, will be expanded to cover all adults earning less than 133 percent of the federal poverty level. A number of the provisions of the bill will likely affect oncology care, including insurance reforms, coverage of clinical trials, and an increase in accountable care organizations.

More Legislative Updates
The Sustainable Growth Rate (SGR) still does not have a long-term fix in place. Instead, a series of short -term fixes have delayed the 21.2% cut from taking effect. First, Congress passed a two-month fix that lasted through February. On March 2, Congress passed another short-term fix that ran for one month, giving Congress until the end of March to develop a longer-term fix. The House of Representatives passed another one month fix, but the Senate was not able to pass anything before leaving for recess. Consequently, CMS has ordered its contractors to hold all claims for 2 weeks, assuming that the Senate will pass another fix when returning on April 12. This would be another one month fix through the end of April. After that, it appears likely that we will see a short term fix that takes us through the end of the government’s fiscal year in September, or one running through the end of the calendar year.

Regulatory Updates
The large proposed cuts for physicians did not take place, thanks to the comments of many organizations such as ACCC. However, CMS did not totally eliminate the cuts; it simply delayed them so they will take effect over four years. In 2010, medical oncologists will have roughly a 1% cut with radiation oncologists receiving the same decrease. While E&M codes did see an increase in 2010, the elimination of consultation codes may be difficult for oncologists going forward. Not only does this ruling create more confusion, it also decreases the payments for services the physicians were providing during consultations.

On the hospital side, while many administration codes saw increases in their payments, drug reimbursement remains lower than in the physician office setting. CMS also made a major change to its physician supervision requirements. Thanks in large part to the efforts of ACCC and other groups, CMS changed its rule and will allow non-physician practitioners to supervise procedures if permitted by their state practice acts and their hospital granted privileges. This has been, and continues to be, a major source of concern and confusion for hospitals across the country, and ACCC is continuing to work to clarify this issue.

This year will be a busy one for health-related issues: we can expect more from healthcare reform in the spring, the proposed CMS rules in the summer, the final rules in the fall, and the debate over a long-term SGR fix in the winter. If you have any questions, please email mfarber@accc-cancer.org.

Drugs in the News from NOS
Corporate Members

The FDA approved Genentech Inc.'s (South San Francisco, CA) anti-cancer drug Rituxan® (rituximab) to treat certain patients with chronic lymphocytic leukemia (CLL). Rituxan is intended for patients with CLL who are beginning chemotherapy for the first time and for those who have not responded to other cancer drugs for CLL. Rituxan is administered with two other chemotherapy drugs—fludarabine and cyclophosphamide. Click here for more information.

The FDA has approved an expanded indication for lapatinib (Tykerb, GlaxoSmithKline) in combination with letrozole (Femara, Novartis AG) for the treatment of hormone-positive and human epidermal growth factor receptor 2 (HER2)–positive advanced breast cancer in postmenopausal women for whom hormonal therapy is indicated. Lapatinib previously was approved in combination with capecitabine (Xeloda, Hoffmann-LaRoche, Inc) for the treatment of advanced or metastatic HER2-positive breast cancer in patients who have received prior therapy including an anthracycline, a taxane, and trastuzumab. Click here for more information.

For more information about The Nevada Oncology Society (NOS)
go to www.nos-nevada.com
or call 301.984.9496, ext. 218

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