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Major Cancer Bill Introduced in Senate

Major Cancer Bill Introduced in Senate

Sen. Dianne Feinstein (D-Calif), whose second husband died of colon cancer, seems to be following in the footsteps of retired Sen. Connie Mack, once the leading advocate of cancer care legislation in the Senate. Sen. Feinstein’s new bill, the National Cancer Act of 2002, has an array of provisions including at least one that may slow the progress of the legislation. Sen. Feinstein wants to give the Food and Drug Administration (FDA) the authority to regulate tobacco, a proposition that has been presented to Congress before to no avail.

A letter sent to Sen. Feinstein on February 26 by several cancer groups said they strongly support tobacco regulation but have a number of reservations about provisions in the new bill. For example, the bill would cap the growth of the National Cancer Institute (NCI) budget at 10% between fiscal 2004-2007. That cap would be instituted after a 15% annual growth up to fiscal 2003. The letter said, "Such limits on NCI appropriations are at least theoretically inconsistent with the concept of a professional judgment budget."

One provision is directed specifically at oncologists: Public and private health insurance plans would pay oncologists to become overall managers of a patient’s care, or what the senator refers to as "cancer quarterbacks." However, in their letter, the cancer groups pointedly said, "We are concerned that reimbursement for coordination activities as contemplated by the provision will be so insignificant as to have no impact on cancer care." For example, Medicare already has codes for reimbursing oncologists (and other physicians) for referring cancer patients to hospices, but filling out the required paperwork is so time-consuming that oncologists do not use those codes.

Sen. Feinstein believes cancer will be cured in her lifetime. One way she proposes to hasten the arrival of a cure is to provide grants and other incentives totaling $100 million a year for 5 years to spur on the initiation of more clinical trials. approximately 400 new drugs are held up in the development process because the resources to fund research of these drugs are not available, the senator says. In fact, only 5% of adult cancer patients (vs 60% of children) are currently enrolled in clinical trials. The bill also requires that private and public insurance programs cover the routine costs of clinical trials.

These incentives to sponsors of clinical trials would work hand-in-hand with the provision requiring private insurers to pay routine medical costs associated with clinical trials and cover more types of cancer screening tests. In addition, insurers would have to pay for smoking cessation, nutritional counseling, and genetic testing.

There are 28 other senators cosponsoring the bill, including all female members of the Senate (both Republicans and Democrats) but only one male Republican (Sen. Gordon Smith, R-Ore). The lack of GOP male cosponsors and the reservations of cancer groups means that the bill will undergo a relatively long modification process.

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