ASTRO pushes CMS to stop $300M in cuts to cancer care

The American Society for Radiation Oncology (ASTRO) has sent a letter to the Centers for Medicare & Medicaid Services (CMS) opposing proposed policy changes for the 2013 calendar year that would cut nearly $300 million for cancer treatment.

The proposed rule, published July 30 in the Federal Register, would revise several reimbursement payment policies and rates for services furnished under the Medicare Physician Fee Schedule as of Jan. 1, 2013.

The most significant portion of the cuts would reduce reimbursement rates for delivery of intensity modulated radiation therapy (IMRT) by 40 percent and for stereotactic body radiation therapy (SBRT) by 28 percent due to changes in assumed treatment times.

The letter stressed the need for sound data and a rigorous analytical methodology, rather than reliance on patient education materials, for determining reimbursement rates for physician services.

When Medicare announced the proposed cuts, ASTRO conducted an online survey of its members to determine the possible effects of the cuts. According to nearly 600 individual survey responses from July 7 to 11, the proposed cuts could severely impact community-based cancer care nationwide.

Respondents indicated that they may limit access to care for Medicare patients, close or consolidate practices, delay or not purchase state-of-the-art equipment, and/or lay off or reduce staffing.

To date, more than 30 members of Congress, led by Sens. Debbie Stabenow, (D-MI.) and Richard Burr (R-NC) and Reps. Joe Pitts (R-PA) and Frank Pallone (D-NJ), have pledged to sign letter telling CMS to halt the proposed cuts.

Cancer patients groups also have expressed concern about the potential impact of the cuts. On Sept. 4, the Cancer Leadership Council (CLC) submitted a comment letter recommending that CMS reverse the impending cuts to radiation oncology to ensure that cancer patients will continue to have access to high quality radiation therapy. Signatories on the letter include the American Cancer Society Cancer Action Network, Susan G. Komen for the Cure Advocacy Alliance, the Lance Armstrong Foundation and the National Coalition for Cancer Survivorship.

The proposed rule includes a number of issues of concern to ASTRO, such as the need to: properly account for the appropriate number of radiation therapists during treatment; update equipment costs for IMRT treatment; close the self-referral loophole for radiation therapy services; and identify appropriate interest rates for equipment loans.

ASTRO praised CMS for including the oncology measures group for the Physician Quality Reporting System (PQRS) 2013 and for changing the reporting criteria for measures groups for PQRS 2013-2016.