In accordance with the Medicare Modernization Act of 2003, the Centers for Medicare & Medicaid Services (CMS) is restructuring the administration of the fee-for-service Medicare program. The new system replaces multiple local fiscal intermediaries (Part A) and carriers (Part B) with Medicare Administrative Contractors (MACs) chosen through bidding and open competition. Central to the reform is the creation of 15 new MAC-administered jurisdictions that CMS expects to be fully operational by October 2009.

On the local and regional level, ASCO affiliates are demonstrating the value of collaboration. For example, the Texas Society of Medical Oncology and the Oklahoma Society of Clinical Oncology jointly applied for and received a 2005 to 2006 state affiliate ASCO grant to convene a meeting of the ASCO affiliates whose states comprise the jurisdiction J4 MAC. In November 2006, representatives from Texas, Oklahoma, New Mexico, and Colorado met to consider how the MAC may affect treatment decisions and access to care, and to develop partnerships to protect their own and their patients’ interests.

As ASCO continues making recommendations to help CMS identify meaningful and outcome-oriented performance standards on behalf of Medicare beneficiaries with cancer, ASCO affiliates will work together to establish a unified voice for oncology within their new MAC jurisdictions and to learn from state societies in regions where the transition to a MAC has already taken place.