Radiation oncology sidesteps massive reimbursement cuts for 2010

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Instead of the 19 percent of proposed cuts to radiation oncology, the Centers for Medicare & Medicaid Services (CMS) has decided to implement a 5 percent reduction, phased in over a four-year period in its 2010 Medicare Physician Fee Schedule. As a result, CMS reimbursements for radiation oncology treatments will be reduced by 1 percent in 2010.

Due to a large number of comments that "strongly opposed” the Physician Practice Information Survey (PPIS), CMS agreed it is “more appropriate” to update the weights used to blend the hospital-based and freestanding radiation oncology center survey data based on more recent claims data. However, the agency did not agree to “eliminate the weighting of the survey data, especially with the 21 observations with imputed physician practice hours removed from the survey sample respondent mix.”

In its press release, CMS stated that it will no longer use the PPIS data to determine the practice expenses for medical oncology, but instead will continue to use specialty supplemental survey data, as indicated by the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

This decision came as a huge relief to radiation oncology practices across the United States, as an American Society for Radiation Oncology (ASTRO) survey released in July found that the proposed cuts could have meant many practices would be forced to consolidate, close up or refuse patients.

In fact, those surveyed anticipated that 18 percent of practices would close if the cuts were 20 percent, and 39 percent of practices would close if the cuts were 30 percent. Those surveyed also estimated that 39 percent of practices would consolidate practice locations if the cuts were 20 percent, and up to 60 percent would experience consolidation if the cuts were 30 percent.

As a result, ASTRO called CMS’ reversal a “major victory."

The final rule with comment will appear Nov. 25 in the Federal Register. CMS will accept comments on designated provisions of the final rule with comment period until Dec. 29, and will respond to all comments at a later date. Unless otherwise specified, the new payment rates and policies will apply to services furnished to Medicare beneficiaries on or after Jan. 1, 2010.