Sens. Richard Burr, R-N.C., and Blanche Lincoln, D-Ark., have sent a letter to Health and Human Services Secretary Kathleen Sebelius urging that the Centers for Medicare & Medicaid Services (CMS) spare radiation oncology services from a proposed Medicare reimbursement cut.
An additional 30 senators joined Burr and Lincoln in signing the letter. The group stated they are concerned that the proposed reimbursement cuts could force freestanding and community-based cancer centers to shut down, particularly in rural areas.
At issue is a 19 percent cut in Medicare reimbursement to the radiation oncology specialty contained within the CY 2010 Physician Fee Schedule Proposed Rule, equating to cuts of up to 44 percent for certain radiation therapy treatments. The rule also contains a proposed policy that raises the utilization rate for certain medical equipment from 50 to 90 percent.
The Sept. 23 letter submitted to Sebelius asked CMS to exempt radiation therapy equipment from the proposed utilization rate assumption increase, stating: "Radiation therapy is not diagnostic imaging. Radiation therapy is only provided to beneficiaries who have already been diagnosed with cancer. Equipment used to both treat cancers and guide the treatment is not diagnostic in nature. Instead, it is used to ensure that the dose of radiation required to kill the tumor is delivered to the tumor and not surrounding healthy tissue. We therefore urge that CMS exempt non-diagnostic imaging equipment from the proposed utilization rate assumption increase."
Oncology providers also urged CMS to reconsider its proposed cuts.
“We understand and share policymakers’ concerns in the need to make certain that payments for medical procedures are appropriate—but established scientific data should be used as a roadmap for such payment formulas, which certainly does not apply here in the case of cuts to radiation oncology services,” said Leonard Kalman, MD, chairman of US Oncology’s Public Policy Steering Committee.