CMS Extends Chemotherapy Demonstration

November 3, 2005 – CMS extends the chemotherapy demonstration another year, and reconfigures the demonstration to focus on evidence-based practice guidelines. Additionally, the final rule on the Hospital Outpatient Prospective Payment System was released, with publication in the Federal Register expected later this month. Updated information on the Competitive Acquisition Program (CAP) was also released. ASH is currently analyzing the final rules and will provide additional information.

The chemotherapy demonstration received a great deal of attention, not all favorable, as the scheduled conclusion approached. Click here to view the letter from the Senate Finance Committee on the chemotherapy demonstration. The demonstration has been extended through 2006, although there are significant changes being implemented January 1.

Reporting will be associated with evaluation and management services for established patients, with a payment of $23. CMS estimates that the revised demonstration will result in approximately $150 million in allowed charges to oncologists. Established patients must have a primary diagnosis of cancer in one of the following categories:

• Breast cancer (invasive)
• Colon cancer
• Rectal cancer
• Prostate cancer
• Lung cancer
• Stomach cancer
• Esophageal cancer
• Pancreatic cancer
• Ovarian cancer
• Non-Hodgkins Lymphoma
• Chronic myelogenous leukemia
• Multiple myeloma
• Cancer of the head and neck

The rule is still under analysis and more details will be posted soon.