Massachusetts Society of Clinical Oncologists Activities
Since the passage of the Medicare Prescription Drug Bill four months ago, MSCO, in conjunction with ASCO, has been working diligently to ensure that the members of the oncology community in Massachusetts are kept as up-to-date as possible during this transition period. The MSCO Board of Directors has had several meetings with the major insurers in the state to determine how these Medicare changes will affect the local carriers. Blue Cross Blue Shield has indicated in several meetings that they are monitoring the situation and, at least for the time being, are not planning to make changes. BCBS has also indicated that MSCO would be contacted for input prior to making any changes. Harvard Pilgrim HealthCare will be changing their reimbursement for their Medicare managed care plan, First Seniority, in line with the Medicare changes. HPHC has also indicated that they presently do not have changes planned in drug reimbursement or administration fees for their other products.
In addition to meeting with the insurers, MSCO board members are also meeting with state and national representatives in an effort to assist ASCO with a proposed bill to freeze Medicare payments at the 2004 level. Representative Barney Frank was most helpful providing constructive suggestions. MSCO Board members will continue to contact legislators as the ASCO initiative proceeds.
MSCO was recently made aware of restrictions Medicaid (MassHealth) was trying to make around the narcotic analgesic class of drugs. An amendment to the Massachusetts House Budget (#995), involves prior authorization for oxycontin and other drugs. Further, this preauthorization for oxycontin applies to all prescriptions, not just prescriptions covered through MassHealth, and could have serious consequences for cancer patients, catastrophically injured patients, or frail elderly patients. The most detrimental portions of the amendment, including the requirement for a photo ID, certification that the prescription is medically necessary, and a diagnosis provided, have recently been withdrawn. MSCO sent a letter to the sponsor of the amendment thanking him for withdrawing these provisions and offering whatever assistance it could to ensure protection of cancer patients’ rights and privacy, while still receiving optimal care.
Of recent concern to Massachusetts’ oncologists is the new Harvard Pilgrim Health Care (HPHC) initiative to engage National Imaging Associates (NIA) to administer a radiology notification and consultation program for non-emergency, outpatient, advanced imaging services. The MSCO Board has drafted a letter to HPHC and the Massachusetts Medical Society (MMS) strenuously objecting to this proposed pre-approval policy and is currently holding discussions with the Massachusetts Medical Society and the specialty society presidents to see if there is any way to further delay or halt the policy entirely.
On a lighter note, MSCO has selected November 4, 2004 as the date for our Annual Meeting. The designated topic will be "Targeted Therapies, and our speakers will include David Schenkein, M.D., George Demetri, M.D. and Karen Anderson, M.D. The Susan G. Komen Foundation has been selected to receive MSCO’s Sullivan Award. MSCO presents this award annually to recognize an individual’s or organization’s outstanding efforts to educate the public about cancer prevention or to enhance and protect the quality of cancer care in Massachusetts.
Click the link below to read the most recent MSCO Newsletter:
Spring 2004 Newsletter.pdf
