Leucovorin Shortage Continues  

As you may know, the market is currently experiencing a leucovorin shortage that is expected to last until mid to late January.  Please contact your ION or Oncology Supply representative with any questions you may have.

The Leukemia & Lymphoma Society has recently updated their pain management fact sheet. It's available at http://www.leukemia-lymphoma.org/attachments/National/br_1222354169.pdf

Houston Chronicle, October 10, 2008 

The Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractors (RAC) program to address fraud concerns has been announced. The program will initially start with four contractors in selected states and will include all the states nationwide no later than 2010. The RAC program mission is to detect and correct past improper payments and to implement actions to prevent further improper payments. Claims with unusually high volume or high dollars will be examined and visits to the providers may also be warranted.

1. Diversified Collection Services, Inc. of Livermore, California, in Region A
   Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and New York
2. CGI Technologies and Solutions, Inc. of Fairfax, Virginia, in Region B
   Michigan, Indiana, and Minnesota
3. Connolly Consulting Associates, Inc. of Wilton, Connecticut, in Region C
   South Carolina, Florida, Colorado, and New Mexico
4. HealthDataInsights, Inc. of Las Vegas, Nevada, in Region D
   Montana, Wyoming, North Dakota, South Dakota, Utah, and Arizona

The October SWON Information Exchange was published on October 2, 2008.  Click here for a copy.

Eli Lilly and Company announced it received approval from the U.S. Food and Drug Administration (FDA) for the use of Alimta (pemetrexed for injection), in combination with cisplatin, in the first-line treatment of locally-advanced and metastatic non-small cell lung cancer (NSCLC), for patients with nonsquamous histology. Alimta is not indicated for treatment of patients with squamous cell non-small cell lung cancer. NSCLC is the most common form of lung cancer, resulting in more than 180,000 new cases in the U.S. each year. NSCLC is defined as a group of histologies, that is, tumor types differentiated by cellular structure. Nonsquamous histology includes adenocarcinoma, large cell carcinoma and all other histologies except squamous cell carcinoma.

For full prescribing and safety information about Alimta, visit www.alimta.com.

The Oncology Clinic Contract that ION has in place with Amgen for purchases of Aranesp® (darbepoetin alfa), Neulasta® (pegfilgrastim) and Neupogen® (filgrastim) has recently been updated.  New contractual terms for all ION members will go into effect on October 1, 2008.

ION has recently entered into an agreement to bring you Fusilev (levoleucovorin) for injection 50 mg single use vials at a special discounted rate through Oncology Supply (OS).  In order to receive this special introductory rate, you must place your order with OS no later than September 30, 2008.

 The following three documents 1. Prescribing Information, 2. Medication Guide (MG) 3.Patient Information for Use (PIU) explain the changes and can be viewed on any one of the following web sites:  www.Procrit.com, www.Orthobiotech.com or www. PROCRITline.com 

BRIDGEWATER, NJ (August 5, 2008)– Ortho Biotech is announcing that it is voluntarily recalling one manufacturing lot (P114942A) of PROCRIT^® (Epoetin alfa) after having identified cracks in the necks of a small number of vials upon post-manufacturing inspection. No other lot of this product is affected by this recall. Approximately 44,292 vials of lot P114942A in the following packaging configurations were distributed between April 15, 2008 and July 17, 2008. 

Effective July 25, 2008, Amgen issued a price increase to the wholesale acquisition cost (WAC) of Aranesp®, Neupogen®, and Neulasta®.  Beginning July 25, 2008 and continuing through January 24, 2009, Amgen is offering a price protection program on all three products.

Effective August 1, 2008, Roche Laboratories will be implementing a Xeloda® contract price change.

Please Click Here for important information from APP Pharmaceuticals regarding the use of Cytarabine.
https://www.oncologysupply.com/content/oncsupply/cms/files/Cytarabine_-_24778.pdf

Background

On July 15, 2008, the Medicare Improvements for Patients and Providers Act of 2008 was enacted, making changes to the Medicare program.  Information about some of the changes is outlined below.  Detailed instructions about these changes have been communicated via listserv to CMS providers and other affected parties.   CMS will be implementing other provisions of the legislation in the coming months and will announce additional information as it becomes available.

Physician Pay

As a result of the new law, the mid-year 2008 Medicare Physician Fee Schedule (MPFS) rate reduction of -10.6 percent is retroactively replaced with the fee schedule rates in effect from January – June, 2008, which reflected a 0.5 percent update from 2007 rates.  In addition, MPFS payment rates are being revised to increase the fee schedule amounts for certain mental health services. 

Effective immediately, CMS has instructed its contractors to implement the new law.  However, it may take up to 10 business days to implement these changes.  To minimize physician disruption during this transition, CMS will post the new physician fee schedule as soon as possible and will continue its rolling 10 day hold and release of claims.  This means that, until the new fee schedule rates are implemented, some claims may still be paid at the lower rates that were in effect between July 1st and July 15th.  To the extent possible, contractors will begin to automatically reprocess any claims paid at the lower rates in a timely manner.  CMS will issue guidance about the collection of corrected co-insurance payments in the next few days. 

More information on physician pay issues is available at http://www.cms.hhs.gov/PhysicianFeeSched/

Therapy Caps

The law also reinstated the therapy caps exceptions process as of July 1st.  Therefore, medically necessary therapy services, in excess of the therapy caps, will continue to be paid by Medicare in accordance with the exceptions process.  Claims submitted with the therapy cap exception modifier will be processed as soon as the payment rates have been activated.  Claims submitted without the modifier, and rejected or denied, can be resubmitted with the modifier for reimbursement.  To the extent possible, claims under the therapy cap limit, which were paid at the lower rate, will be reprocessed automatically.  More information on therapy caps is available at http://www.cms.hhs.gov/TherapyServices/

DME

The Durable Medical Equipment Competitive Bidding Program, which affects only Medicare beneficiaries in traditional fee-for-service in 10 competitive bidding areas, has been delayed.  Medicare beneficiaries may use any Medicare-approved supplier for Durable Medical Equipment.  If a beneficiary changed suppliers when this new program started (July 1, 2008), they can either continue to use the new supplier or choose another supplier.  The original DME payment rates in effect prior to July 1 are reinstated retroactively.  All Medicare households in the 10 competitive bidding areas will be notified of this change directly in a letter from CMS within two weeks. 

The DME Competitive Bidding areas are: (1) Charlotte-Gastonia-Concord, NC-SC, (2) Cincinnati-Middletown, OH-KY-IN, (3) Cleveland-Elyria-Mentor, OH, (4) Dallas-Fort Worth-Arlington, TX, (5) Kansas City, MO-KS, (6) Miami-Fort Lauderdale-Miami Beach, FL, (7) Orlando-Kissimmee, FL, (8) Pittsburgh, PA, (9) Riverside-San Bernardino-Ontario, CA, and (10) San Juan, PR.  Information on payment rates and claims processing will be communicated to DME suppliers in the coming days. 

More information on DME is available at http://www.cms.hhs.gov/DMEPOSCompetitiveBid/

Eisai Corporation of North America recently purchased MGI Pharma Inc., the manufacturer of Aloxi and Dacogen. Eisai decided to renegotiate the Oncology Supply contract and as a result, the cost of acquiring and distributing all their products has increased, most notably Aloxi. Therefore, effective July 15, 2008, Aloxi purchase price will increase. Oncology Supply will honor your current price on Aloxi for all orders placed and shipped prior to that date.

If you are contemplating a larger than normal purchase level prior to the increase on July 15, please contact either your Oncology Supply sales representative or our Customer Service Department in advance so that they can ensure they have sufficient quantities on hand to meet your needs.

The Southwest Oncology Network website is now LIVE! We will continue to populate the website in the coming weeks. Please let us know if you have any recommendations or feedback.