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Changes to levoleucovorin reimbursement for Q3
The ASP plus 6% allowable for J0641 for Third Quarter has been increased from $.646 to $.732 for 0.5 mg. You must re-file to get the increase. |
When practices submit price matches all SWON members benefit! Thanks to the watchful eyes of our members, SWON participating practices are driving down drug costs.
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Lord of the Files
Visit the official blog for guests and subscribers of the Oncology Manager's Briefcase.
Click Here
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| Contact Us
| Melissa Welch
Southwest Oncology Network
6921 Shoreview Drive
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Keep your Membership Current
If there are changes to your phone number, physical address, primary contact etc. or if your practice merges with another organization, please be sure to notify SWON.
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Each quarter SWON prepares a report that compares ASP reimbursement rates to the SWON price book. The report is separated into four worksheets, to provide an overview for each of the payment terms available to SWON members through Oncology Supply. The fourth quarter reimbursement report was distributed on October 6th.
Feedback on the report has been overwhelmingly positive. Members appreciate the easy to understand format and the ability for them to quickly see which drugs may be underwater for the quarter. Our report was calculated based on the Medicare standard of ASP + 6%. However, as was pointed out by the keen eye of one of our members, ASP +6% isn't always an accurate calculation for reimbursement from all payers. Based on this feedback, SWON will be modifying our report for next quarter to include two calculations. We will still provide information on ASP +6%, but will also show straight ASP rates.
If you did not receive the ASP reimbursement report and would like a copy, email Melissa@swonrx.com.
Also - watch your email on the first of each month for a report showing the manufacturer price changes that have occurred during the past 60 days.
As always, SWON is working to provide value in all that we do. If you have suggestions on additional services SWON could provide to our members, please let us know. |
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Reprinted from E-Reimbursement News by Roberta Buell at onPoint Oncology, LLC
Without deliberate congressional action (how about that for an oxymoron?), the SGR formula will result in a 23% reduction in Medicare payments to fee schedule services (not drugs and labs) December 1 and will increase to about 30% January 1, 2011. As you may remember, after a 'hard stop' in claims, Congress for the third time this year approved legislation in June implementing a slight increase in payments through November 30. With Congressional elections coming up and the resulting resistance to additional spending, there are doubts that this Congress will get it done. It might just be that a temporary fix of just two months may be all we get from a Lame Duck Congress, which seems to have been lame for a long time. This may mean that we will need to go through more anxiety attacks every few months next year.
In response to this, the American Medical Association (AMA) recently asked House and Senate lawmakers for a 13-month patch that would block the scheduled 30% pay cut to doctors in 2011. A letter signed by all of the state medical societies and more than sixty national medical societies, incuding ASCO, requests a thirteen month patch for all of 201. This would relieve physicians from the crazy dance that has been going on in a year where we have had 4-5 conversion factors, depending upon what you are counting.
AMA has consistently lobbied for a permanent SGR repeal, but the projected cost is just too high and the AMA is not the force it used to be. My guess is that we will never see a permanent fix to the SGR. This can mean one of two things: claims will be held on and off while Congress passes patches each year; or, someone will admit that the Medicare fee schedule formulae do not work and will invent a new payment system. Stay tuned for more SGR fireworks... |
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Prostate Cancer Drugs - GnRH Agonists Linked to Diabetes and Heart Disease Risk |
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A type of drug given to men with prostrate cancer, called GnRH (gonadotropin-releasing hormone) agonists have been linked to a higher risk of developing diabetes, stroke or heart disease, and thus must have new warnings on their labels, said the US Food and Drug Administration (FDA). An ongoing analysis which started in May this year found that men on GnRH agonists had a slightly elevated risk of having a heart attack, becoming diabetic, suffering from a stroke, or sudden death. |
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New tumor proteins may identify a range of cancers early
COLUMBUS, Ohio - A new study led by Ohio State University cancer researchers describes a novel cancer-specific protein that is present in a broad range of cancer types and at all stages of tumor development, from premalignant cells to metastatic tumor cells.
If verified, the antigen could serve as a marker for the early detection and treatment of primary and metastatic tumors, and provide a target for the development of anticancer therapies, the researchers say.
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Suggested Reading
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 Eat That Frog!
By Brian Tracy
(as described on amazon.com)
The legendary Eat That Frog! (more than 450,000 copies sold and translated into 23 languages) provides the 21 most effective methods for conquering procrastination and accomplishing more. This new edition is revised and updated throughout, and includes brand new information on how to keep technology from dominating our time.
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