ASCO Recognizes Oncology Practices Cannot Sustain Further Cuts;
ASCO Moving Quickly to Counter CMS Proposal
July 2, 2009
As we reported yesterday, CMS released its proposed physician fee schedule for 2010, which includes a 6 percent cut in Medicare payments for medical oncology services. This cut is on top of a scheduled 21 percent reduction to the Medicare conversion factor due to the flawed sustainable growth rate (SGR) formula.
While Congress has indicated a willingness to provide a fix to the SGR to avert the 21 percent reduction, it is unclear how or when this would happen. Even taken alone, the 6 percent cut in overall payment, if implemented, would severely hamper the ability of oncologists to continue providing care to people with cancer.
What Is ASCO Doing?
CMS’ actions are a serious threat to the cancer community, and we are prepared to take aggressive steps on all of the issues outlined below:
- CMS based its proposed reduction on information provided through an AMA survey, undertaken earlier this year to collect updated data on physician practice expenses per hour. Data was submitted for medical oncology from only 50 practices. This sample grossly under-represents practicing oncologists and in no way reflects the true costs to practices. ASCO promptly communicated with CMS on this point and will continue to advocate that this survey provides an unbalanced perspective on the full cost of providing quality care to people with cancer.
- In addition, in adopting new data, CMS has abandoned the use of previous criteria put in place to ensure the quality of surveys used to provide information about practice expense. We are deeply concerned that the agency is proposing to use substandard data to make changes to the Medicare program that will have a far reaching impact.
- Oncology is one of only a few medical subspecialties that have been targeted for proposed cuts. Oncology cannot sustain further payment reductions at a time when the number of people with cancer is increasing, practice expenses are increasing, and the oncology workforce is dwindling.
- CMS estimates the overall impact of policy changes on medical oncology at negative 6 percent. The service level impact for chemotherapy administration is even more drastic. Payments for core chemotherapy administration services such as IV chemotherapy infusion would be cut by more than 20 percent if these proposals are finalized.
- CMS has proposed eliminating payments for consultation codes and instead classifying consultations as E & M visit codes without providing a full discussion of the impact of this decision on specialties like oncology.
ASCO is undertaking an in-depth technical analysis of all of the provisions of the proposed fee schedule and will be providing you with more detailed information in the near future. We also are communicating with our sister societies that are in similar positions. Working together, we will make CMS and Congress aware in no uncertain terms that any payment cuts to essential care services will devastate patient care in this country.
What Can You Do?
Clearly, the oncology perspective did not come through in the AMA survey.
Please make your voices heard.
Congress is on recess this week. Your Representative and Senators are home over the July 4 weekend and may be holding local events. Make it personal. Consider attending such a meeting to let your Members of Congress know first-hand how this proposed cut will affect cancer patients and your practice.
Next week, when Members of Congress return to Washington, we will be sending a specific request to urge you to reach out to your representatives. In the meantime, ASCO is on Capitol Hill almost every day, actively representing your interests to leaders in Congress.
Now is the time to fight. We are redoubling our efforts to ensure that oncology practices are heard and that any proposed reductions in payments to oncology practices are blocked.
Contact ASCO’s Cancer Policy & Clinical Affairs Department at 571-483-1670 or
publicpolicy@asco.org with any immediate questions that you have.
