Payment and coverage issues affecting medical oncology.

Medical oncologists continue to face significant issues in obtaining full payment for and coverage of their services by third-party payers. A number of issues raised by the Medicare fee schedule have, however, been at least partially resolved in a favorable manner. There continue to be problems in coverage of off-label drug uses and services associated with clinical trials. The impending reform of the health care system may improve the situation or it may give rise to further difficulties.