House health reform bill calls for self-referral study
After a year's worth of hard work and advocacy, ASTRO has secured language in the
House health reform bill to study practice patterns of self-referral in radiation therapy. This study would serve as a crucial first step to develop hard evidence documenting abuses of the self-referral law in radiation therapy. This language is a clear indication that Congress is hearing our concerns. We will continue to advocate for the inclusion of this study in the health reform package.
The Senate is gearing up for a vote next week to fix the long-time flawed sustainable growth rate formula (SGR). Call your senators to tell them vote YES on S. 1776.
On October 21 the Senate failed to approve a motion to invoke closure on the motion to proceed to the consideration of S. 1776, the Medicare Physician Fairness Act of 2009. The procedural measure required 60 votes in order to limit debate and move forward with the consideration of the bill. The vote was 47-53. The bill, which is estimated at roughly $245 billion and is not offset, would have replaced the sustainable growth rate (SGR) beginning in 2010 with a permanent freeze to payments under the Medicare physician fee schedule (PFS).
AMA advocates supporting healthcare reform
The American Medical Association released its rationale behind supporting HR 3200, the House-passed healthcare reform bill. Specifically, the AMA supports the House bill because it would realize several high-priority goals such as extending coverage to the uninsured, making investments in the physician workforce and providing long-term relief to the Medicare’s flawed physician payment formula. To learn more about the AMA’s position on healthcare reform, you can read the message from AMA President J. James Rohack, M.D.
ASTRO urges Obama to double cancer research funding
The One Voice Against Cancer (OVAC) coalition, of which ASTRO is a member, sent a letter to U.S. Representative David Obey, chairman of the House Committee on Appropriations, urging him to support President Obama's goal of doubling cancer research funding at the NIH over the next eight years and the entire NIH budget over ten years. This would sustain funding for NIH and NCI to continue cancer research, create a preemptive model for prevention, early detection and care, and find advances in developing early detection and treatment models in cancers, where they currently don't exist, and ultimately decrease the costs associated with cancer. In June three ASTRO members Pamela Hall, R.N., Eduardo Moros, Ph.D., and Nicklas Oldenburg, M.D., attended OVAC's annual lobby day on Capitol Hill asking members of Congress to support these requests. For more information, contact Dave Adler, assistant director of government relations.
ASTRO urges addressing self-referral in reform bill
ASTRO has submitted comments to the Senate Finance Committee on the panel’s initial proposals that will form the backbone of health reform legislation. In two letters, dated May 15 and June 1, ASTRO commented on proposals for transforming the healthcare delivery system as well as expanding healthcare coverage and financing comprehensive reform. Consistent with ASTRO’s legislative priority for 2009, the letters called attention to abuses of the physician self-referral law involving radiation therapy and asked the committee to remove radiation therapy from the law’s in-office ancillary services exception, which would improve quality, empower patient choice and reduce inappropriate expenditures. ASTRO also asked the committee to avert the 21 percent Medicare physician payment cut while repealing the program’s physician payment formula. ASTRO noted concerns about the use of benefit managers and support for some proposed improvements to Physician’s Quality Reporting Initiative. The letters approved of prohibiting pre-existing conditions in health plans and praised the committee for recognizing the importance of coverage for cancer treatment, including radiation therapy. For more information, contact Emily Wilson, director of government relations.
Budget plan represents ASTRO self-referral win
Last week, Congress approved the 2010 budget blueprint that includes important language opening the door to a legislative solution to end self-referral abuses in radiation therapy. ASTRO staff confirmed with the House Budget Committee that modifications to physician self-referral are relevant to references in the budget plan to both “changing incentives to encourage efficiency and higher quality care in a way that supports fiscal sustainability” and “holding providers accountable for their utilization patterns and quality of care.” ASTRO staff and members worked with House Budget Committee Chairman John Spratt (D-S.C.) to educate him and his staff on loopholes in the physician self-referral law in radiation therapy that are limiting patient choice and potentially leading to inappropriate care. ASTRO staff also worked closely with Rep. Parker Griffith, M.D. (D-Ala.), who March 19 wrote a letter to Chairman Spratt urging him to add language addressing this loophole in the budget resolution. During Advocacy Day in March, 96 ASTRO members met with more than 150 congressional offices and 334 ASTRO members contacted hundreds of offices, urging lawmakers to support Dr. Griffith’s call for action on self-referral in the budget resolution. While the resolution does not have the force of law, it paves the way for healthcare reform legislation and potentially action on self-referral later this year. ASTRO staff continues to work with key lawmakers and the Obama administration to advocate for removal of radiation therapy from the ancillary services exception to the self-referral law.
Finance Committee releases first health reform paper
Last week, Senate Finance Chairman Max Baucus, D-Mont., and the panel’s top Republican, Sen. Charles E. Grassley of Iowa, released options for potential changes to Medicare reimbursement for a wide range of services and procedures performed by hospitals and doctors. The document includes options to avert the 21percent Medicare physician payment cut and several proposals for differential payment for physicians and other providers. Options include bonuses of up to 5 percent for some evaluation and management services typically provided by primary care physicians as well as penalties of up to 5 percent for not meeting quality and other standards, which represents significant differences in payments. The proposal also includes requiring self-referring physicians to provide patients with written notification of alternative locations for imaging. This is the first in a series of a three documents that is expected to be released by the Senate Finance committee. The next document is expected in the next few weeks.
