Senators Ask Medicare To Stop Radiation Therapy Cuts

Ruzanna Harutyunyan's picture
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The American Society for Radiation Oncology (ASTRO) applauds Blanche Lincoln (D-Ark.) and Richard Burr (R-N.C.) and 30 of their Senate colleagues for spearheading efforts to protect access to life-saving treatments for the nation’s cancer patients by asking Medicare to stop proposed cuts to cancer care.

The bipartisan group of Senators today sent a letter to U.S. Health and Human Services Secretary Kathleen Sebelius protesting severe cuts proposed in the Medicare physician fee schedule for radiation oncology services. While the Centers for Medicare and Medicaid Services (CMS) projects the overall impact of the payment reductions to be 19 percent, the rates for certain needed cancer services would be reduced by up to 44 percent. An ASTRO survey conducted in July said cuts of this scale would have a particularly devastating effect on community-based cancer centers and the patients they treat.

“We are concerned that these proposed cuts could force freestanding and community-based cancer centers to close their doors, limiting access to cancer care for our seniors, and particularly for those living in rural areas. We urge CMS to reconsider the proposed reductions in Medicare payment for radiation oncology services…” wrote the Senators. “We urge CMS to consider recalibrating specialty reimbursement to support primary care in a way that does not place a disproportionate burden on any one specialty provider group.”

“Cancer patients, who are fighting day in and day out against their disease, already have enough to worry about without having to face additional expense and time to get important treatments. These Senators recognize that these cuts would limit access to care for cancer patients at a time when America is engaged in the essential effort to reform health care to improve access to care,” said Patricia Eifel, M.D., FASTRO, a radiation oncologist at M.D. Anderson Cancer Center in Houston and Chairman of ASTRO. “Radiation oncologists and their patients greatly appreciate the commitment and leadership of Senators Lincoln, Burr and their colleagues to protect cancer care.”

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The Senate letter comes on the heels of a similar letter sent Aug. 17 to Secretary Sebelius by 63 Representatives, led by Reps. Lois Capps (D-Calif.), Sue Myrick (R-N.C.), Mike Rogers (R-Mich.) and Parker Griffith (D-Ala.). With the addition of the Senate effort, nearly 100 Members of Congress now have signed letters to HHS protesting the proposed cuts. ASTRO also supports Sen. Lincoln’s amendment to the health reform plan being considered this week by the Senate Finance Committee to prevent the proposed equipment utilization rate increase from taking effect.

New technology and improved techniques have allowed radiation oncologists to dramatically improve how they target radiation to more effectively eliminate cancer cells while protecting healthy tissue. This has allowed radiation oncologists to improve cure rates while decreasing painful side effects, allowing patients to not only survive, but thrive after their cancer treatments.

ASTRO submitted official comments last month asking CMS to stop its proposed changes to the Medicare payment rates for physician services, including radiation oncology. Specifically, ASTRO wrote CMS urging it to withdraw its proposal to increase the equipment utilization rate for radiation therapy. ASTRO also asked CMS to delay implementation of new physician practice information survey data pending a review of the information and a response to ASTRO’s concerns.

The extreme cuts are due in part to CMS increasing the utilization rate for equipment costing more than $1 million from 50 to 90 percent. By increasing the utilization rate, the payment for each service is reduced significantly. CMS did not reference any actual data for radiation therapy equipment in proposing to increase the rate to 90 percent, basing its proposed change on expanding a Medicare Payment Advisory Commission (MedPAC) recommendation focused on diagnostic imaging equipment. In its Aug. 31 official comments on Medicare’s proposal (available at www.medpac.gov), MedPAC said it “did not contemplate” applying its recommendation to increase the equipment utilization rate to radiation therapy machines.

“Congress has made its will very clear on this issue,” Laura I. Thevenot, ASTRO’s CEO said. “We are hopeful that Congress’ wishes, MedPAC’s comments, actual equipment utilization data, identified problems with the new practice expense survey data, and details on the severity of the impact will all lead to a positive outcome for cancer patients and their caregivers.”

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