Reps. Pitts, Pallone, Rogers support efforts to stop cuts
In a conference call briefing at 11:15 a.m. Eastern time today, ASTRO released the results of its recent member survey in response to proposed Centers for Medicare and Medicaid Services (CMS) payment cuts to radiation oncology. The results of this online survey, conducted July 7-11, 2012, illustrate the potentially devastating effect of these cuts on cancer patients.
ASTRO is working with radiation oncologists and cancer team professionals to protect patient access to cancer care by preventing the proposed Medicare cuts.
According to nearly 600 individual survey responses, the impact of the proposed Medicare payment cuts could severely impact community-based cancer care across the country.
- Access to care for Medicare patients could be limited: 70 percent reported they might have to limit Medicare patients, and 49 percent said they may be forced to no longer accept Medicare patients, resulting in access to care issues for these patients.
- Cancer centers may close: 35 percent of respondents in free-standing centers said they may close their practice. 64 percent could have to consolidate practice locations, which would lead to longer travel times for patients to get daily treatments.
- Possible economic loss to communities: 53 percent of community-based practices may lay off physicians, and 81 percent of community-based practices may lay off professional staff such as nurses.
- Access to state-of-the-art technology could be impacted: 93 percent could delay or cancel purchasing new, state-of-the-art technology, which would affect treatment options for these patients.
“This survey underscores that these cuts would be a severe set-back in our fight against cancer,” said Leonard L. Gunderson, MD, MS, FASTRO, chairman of ASTRO’s Board of Directors.
The July 6, 2012, CMS Medicare Physician Fee Schedule proposes to significantly cut the reimbursement rate for radiation oncology services, beginning January 1, 2013. These cuts represent a 15 percent reduction in overall payment, nearly a $300 million loss for cancer care services. Community-based radiation therapy clinics would be most affected by these cuts with a 19 percent reduction hitting these centers.
The most significant portion of the cuts, 7 percent overall, is due to a change in the treatment times for IMRT, intensity modulated radiation therapy, and SBRT, stereotactic body radiation therapy. IMRT and SBRT include tailor-made treatment plans for each patient, designed to spare healthy organs and tissue. Instead of using the established process for valuing Medicare services, CMS relied heavily on information from patient education materials to support the proposed new treatment times for IMRT and SBRT. The materials cited by CMS are inappropriate for serving as the basis for such dramatic reimbursement changes. Patient information materials are designed for patient education purposes and do not reflect the necessary clinical methodology and professional analysis to value complex medical procedures. The recommended treatment times do not fully account for the time spent positioning the patient for treatment, performing safety checks or the work that occurs before and after each patient’s treatment.
“ASTRO welcomes a comprehensive review of these procedure codes and supports the necessary sophistication of a process, such as provided by the AMA Relative Value Update Committee (RUC), to value complex medical procedures including IMRT and SBRT,” said Michael Steinberg, MD, FASTRO, president of ASTRO’s Board of Directors. “These processes are in place to ensure that such important policy decisions are made fairly, with relevant professional input.”
A bipartisan group of members of Congress have also expressed their concerns about the proposed radiation oncology cuts. Reps. Joe Pitts (R-Pa.) and Frank Pallone (D-N.J.), the respective chairman and ranking member of the House Energy and Commerce Committee health subcommittee, with support from Rep. Mike Rogers (R-Mich.), are circulating a letter among their colleagues that ultimately will be sent to the administration. A similar bipartisan letter is being drafted in the Senate.
“We need to stand up for cancer patients in Pennsylvania and across the country against inappropriate cuts that will limit access to care,” Pitts said. “Cancer patients have enough on their plate without having to worry about their treatment centers closing or being forced to limit treatment options.”
“Access to life-saving radiation therapy near their homes is critical for cancer patients in New Jersey and across the country,” Pallone said. “The process CMS used for coming up with these significant payment cuts raises big questions and could pose serious problems for cancer patients. To ensure that payment is fair and access to radiation therapy for patients is preserved, I want the agency to reconsider their approach.”
“We are pleased that Congress is questioning the magnitude of the cuts to radiation oncology and CMS’ basis for the proposed policy changes,” said ASTRO CEO Laura Thevenot. “It’s very telling that concern about the proposed cuts spans the partisan divide. We applaud Reps. Pitts, Pallone and Rogers and the many others who will join them in standing together on behalf of cancer patients and their health care providers.”
ASTRO’s member survey, conducted online from July 7-11, 2012, had 599 total respondents, and 58 percent of those respondents are from community-based or combined community- and hospital-based practices; the featured results reflect only their responses.
Detailed results of the ASTRO member survey.
Congressional letter of support.
View how patients can become involved?