ASTRO comments on proposed Medicare Physician Fee Schedule
The American Society for Radiation Oncology (ASTRO) submitted comments on the CY 2011 Medicare Physician Fee Schedule to the Centers for Medicare and Medicaid Services (CMS) by the August 24, 2010 deadline. ASTRO also submitted separate comments with a coalition of organizations concerned about abuses of the physician self-referral law.
ASTRO comments to FDA on device safety
On July 15, ASTRO filed comments with the Food and Drug Administration (FDA) advocating for enhanced collaboration among users, independent evaluators and vendors to improve device safety and effectiveness. The letter emphasized the need for a national medical event reporting system for radiotherapy administrations and recommended enhanced training and quality management. The comment letter follows on the FDA public meeting in June, titled “Device Improvements to Reduce the Number of Under-Doses, Over-Doses, and Misaligned Exposures from Therapeutic Radiation.” ASTRO will continue its collaboration with the FDA, industry, professional organizations and others to identify issues impacting radiotherapy safety and to assist the FDA in crafting viable solutions. For more information, contact ASTRO’s senior legislative and regulatory analyst, Richard Martin.
Information session scheduled on EHR program
The Centers for Medicare and Medicaid Services and The Office of the National Coordinator for Health Information Technology are offering an audio training on the final rules for the Medicare Electronic Health Record Incentive Programs. The call is scheduled for July 22, 2010, from 2:00 p.m. - 3:30 p.m. Eastern time. The call-in number is 1-877-251-0301and the conference ID passcode is 87841621. More information on the incentive program can be found at
www.cms.gov/EHRIncentivePrograms.
HHS releases final EHR incentive program rules
On July 13, 2010, Health and Human Services Department (HHS) agencies released final rules for defining meaningful use of electronic health records and standards for certifying records for the new Medicare and Medicaid EHR incentive programs. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.In comments on earlier incentive program proposals, ASTRO urged HHS to ensure that outpatient physicians are eligible for the program and standards are relevant to radiation oncology. ASTRO staff is reviewing the rules and will provide more information on their content.
Despite opposition, Obama appoints Berwick CMS chief
On July 7, 2010, President Obama made a recess appointment of Donald M. Berwick, M.D., to lead the Centers for Medicare and Medicaid Services (CMS). Obama nominated Dr. Berwick in April to be CMS administrator, but Republicans have criticized the nomination, arguing that Berwick supports "rationing" health care services. The recess appointment bypasses the need for Senate confirmation but only allows Dr. Berwick to serve in this capacity until December 31, 2011. The White House said the unusual step is necessary to ensure that a CMS chief is in place to implement numerous provisions of the health care reform law. ASTRO supports the pick of Dr. Berwick to head CMS, as do many other physician and health care groups, and looks forward to working with him on reimbursement and to end self-referral abuses in radiation oncology.
MedPAC testifies to House panel on self-referral
At a June 23 House Energy and Commerce Committee hearing, on the Medicare Payment Advisory Commission's (MedPAC) June 2010 report, several members of Congress expressed concern about abuse of the physician self-referral law's ancillary services exception. MedPAC's report examined various aspects of Medicare, including a chapter on the ancillary services exception to the self-referral law, but it did not submit any specific recommendations. Rep. John Shimkus (R-Ill.) said there are "concerns over rapid growth on ancillary services in physician offices." He noted that not all the services in the exception are the same and said, "We must use caution to not paint all ancillary services with the same broad brush . . ." Rep. Anna Eshoo (D-Calif.) said that she agreed with experts who say self-referral is a "costly drain on the Medicare system." She complained that the report lacks concrete recommendations on self-referral, and she pushed MedPAC Chair Glenn Hackbarth to move faster on recommendations to end self-referral abuses. He responded that there would be more details to come this fall. ASTRO staff has had numerous meetings with the committee members, including its Chairman Henry Waxman (D-Calif.) who asked GAO to study this issue, to educate them about abuse of the self-referral law in radiation therapy. For more information, contact Dave Adler.
Six-month SGR fix passes – claims scheduled to be processed with 2.2 percent increase
On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.” This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The 2.2 percent update would replace the 21 percent Medicare cut currently in effect. The Centers for Medicare and Medicaid Services (CMS) has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered June 1, 2010, and later, until new rates are uploaded and systems tested. CMS expects to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual. Claims containing June 2010 dates of service which have been paid at the negative update rates will be automatically reprocessed as soon as possible; providers should not resubmit claims.
ASTRO weighs in support of temporary SGR fix
Congressional leaders announced plans to vote on an "extenders bill" early this week and include a new proposal to avert the 21 percent sustainable growth rate cut scheduled to take effect on June 1, 2010. The revised SGR proposal is expected to include a 1.3 percent Medicare payment update for the remainder of 2010, a 1 percent payment update in 2011 and updates for 2012-2013. While this plan is less than the absolute solution radiation oncologists have sought, it allows Congress time to continue working through the difficult issues necessary to finally repeal the payment formula. ASTRO supported the proposal, recognizing that if the temporary fix does not pass, then physician payment cuts will begin to take effect. Please contact your member of Congress in support of this legislation before Congress heads into Memorial Day recess.
FDA announces public meeting on radiation therapy device improvements
The FDA will hold a public meeting "Device Improvements to Reduce the Number of Under-doses and Misaligned Exposures from Therapeutic Radiation," on June 9-10, 2010, in Gaithersburg, Md., to discuss steps that could be taken by manufacturers of linear accelerators, radiation therapy treatment planning systems and radiation therapy simulators to help reduce misadministration. The meeting will feature roundtable discussions on device improvements for radiation therapy devices and for software, steps manufacturers can take to improve user training, and quality assurance measures. The FDA is seeking experts who would like to participate in these discussions and others who would like to make presentations. All attendees must preregister. Additional information on the meeting and online registration is available at www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/ucm211110.htm.
ASTRO supports GAO study of self-referral in radiation oncology
The American Society for Radiation Oncology (ASTRO) applauds the leadership of Reps. Pete Stark (D-Calif.), Sander Levin (D-Mich.) and Henry Waxman (D-Calif.) for requesting, in an April 16, 2010, letter, that the Government Accountability Office (GAO) study the impact on patient care and Medicare spending on radiation oncology services provided in physician self-referral arrangements. Check out the Web exclusive on What's Happening in Washington.
