ASCO, CMS, DHCS/MediCal, & Corporate Member News

****ASCO NEWS****
Prompt-Pay Legislation Introduced in House of Representatives
Please Urge Your Representative to Co-sponsor H.R. 1392

Reps. Gene Green (D-TX), Ed Whitfield (R-KY), Diana DeGette (D-CO), Mike Ross (D-AR), Edolphus Towns (D-NY), Mike Rogers (R-MI), Betty Sutton (D-OH), Bart Gordon (D-TN), Lee Terry (R-NE), and Ralph Hall (R-TX) have introduced legislation to address an issue with the calculation of the Average Sales Price (ASP) for Medicare Part B drugs. We thank and applaud them for their leadership on this important issue.

The bill, H.R. 1392, would remove prompt-pay discounts extended to wholesalers from the ASP calculation.

ASCO, along with members of the cancer community, supports this legislation and has long been working on Capitol Hill to make members of Congress aware that including prompt pay discounts in the ASP calculation threatens community oncology practices by artificially lowering the reimbursement rate for chemotherapy treatments. In the 110th Congress, ASCO worked with members of Congress to introduce similar legislation.

Significant support of this legislation is critical to its consideration and passage. Please contact your Representative in the House today and urge him or her to co-sponsor H.R. 1392. It is important to let them know the impact that underwater drugs are having on your practice and your patients. You can find contact information for your Representative on ASCO's Grassroots Action Center.

For more information, contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org.


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the new Electronic Prescribing Incentive Program (E-Prescribing) web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website. All information about the E-Prescribing Incentive Program has been moved from the CMS PQRI web page at http://www.cms.hhs.gov/PQRI to http://www.cms.hhs.gov/ERXIncentive.

This new web page provides information about the new E-Prescribing incentive program that was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

Please note that many new resources have also been added to the E-Prescribing Incentive web page as part of the migration to the new URL.

Included on this page in the Downloads section is:

• A 2009 Electronic Prescribing (E-Prescribing) Incentive Program Made Simple Fact Sheet;
• A Spanish version of the Introduction to E-Prescribing Incentive Fact Sheet;
• A Sample Electronic Prescribing Claim; and
• Information on how to access the audiotapes and slides from the National E-Prescribing Conference that was held in October 2008 for continuing education credit.

New and updated information will continually be added, so please visit the Electronic Incentive Program web page at http://www.cms.hhs.gov/ERXIncentive on the CMS website on a frequent basis.


****DHCS/MEDICAL NEWS****
The implementation date is fast approaching! Providers are reminded that, claims with dates of service on or after April 1, 2009 that do not meet the NDC reporting requirements to include a valid NDC with a HCPCS code, will be denied. For more information on NDC reporting, including FAQs, please visit the NDC page on the Medi-Cal Web site at: http://files.medi-cal.ca.gov/pubsdoco/ndc/ndc.asp

In order to comply with the DRA, providers must bill for physician-adminstered drugs using the appropriate CPT-4, HCPCS Level II, or local HCPCS Level III codes and, in addition, must include the NDC on the claim form. Providers have been encouraged, for dates of service on or after September 1, 2008, to include the NDC code on the claim, but claims without an NDC code have still been paid. Unfortunately, we are seeing minimal voluntary submissions of NDC and now is the time for providers to practice how they are going to comply.

Resources
The ASC X12N Version 4010A1 Companion Guides have been updated and are available on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/hipaa/hipaaspecs_home.asp . These guides will enable technical staff or software vendors to update your software to include the NDC requirements on the 837 electronic transactions. Additionally, the Part 2 provider bulletins (General Medicine, Obstetrics and Outpatient) include NDC information, physician-administered drug definitions, billing descriptions and examples for CMS 1500 and UB-04 paper claim forms, as well as both 837 Institutional and Professional electronic formats, and Section 340B information. These bulletins can be viewed on the Medi-Cal Web site at http://files.medi-cal.ca.gov/pubsdoco/Bulletins_menu.asp . Finally, the CMS 1500 and UB-04 claim form tutorials on the Medi-Cal Web site have been updated to include instructions on how to bill HCPCS and NDCs and can be viewed at: http://files.medi-cal.ca.gov/pubsdoco/eo/elearning.asp .

Provider Workshops
There will be additional overviews presented at the Medi-Cal seminar, to address the NDC reporting requirements, in Long Beach on 3/24 and 3/25. The locations of the sessions and how to pre-register can be found on the Medi-Cal Web site: http://files.medi-cal.ca.gov/pubsdoco/eo/training.asp

Please share this information with your membership, including a notice in your newsletters. Should you have any questions or need additional information, please call the Telephone Service Center (TSC) at 1-800-541-5555 and choose the appropriate prompt or visit the Medi-Cal Web site at the address listed above.


****CORPORATE MEMBER NEWS****
Oncology Reimbursement Solutions, a service of US Oncology, is hosting a webinar entitled "E/M Documentation: Woud Yours Survive an Audit?" taking place on Tuesday, March 17th and Wednesday, March 18th.

For more information, please visit www.ors-insight.com/orsoncology.