ASTRO joins groups seeking fair, transparent Practice Expense methodology
September 12, 2022
ASTRO has signed onto two group letters that seek to address recent cuts associated with Clinical Labor Price Input updates, as well as secure a transparent, stakeholder-focused process associated with anticipated updates to the Physician Practice Information Survey tool. Both policies are components of the Practice Expense methodology, which is used to value direct and indirect practice expenses as part of the Medicare Physician Fee Schedule payment methodology. Modifications in recent years have led to rate cuts for radiation oncology, as well as other specialties that rely on expensive equipment and technology, due to the budget neutrality constraints.
ASTRO signed onto a letter supported by specialties representing freestanding physician practices that were disproportionately impacted by the Centers for Medicare and Medicaid Service’s (CMS) decision to update the Clinical Labor Price inputs over a four-year period beginning January 1, 2022. While supportive of the long overdue update that resulted in increased salary rates for clinical providers, such as medical physicists, radiation therapists, and dosimetrists, the increase came at the expense of services that require the use of expensive equipment and technology due to budget neutrality constraints, which shifted $3.6 billion away from radiation oncology and other services to fund the clinical labor update. The coalition letter was sent to Reps. Bobby Rush (D-Ill.) and Gus Bilirakis (R-Fla.), seeking their continued support for a legislative remedy that would add new funding to the Medicare Physician Fee Schedule (MPFS) to increase the practice expense inputs that were negatively impacted by the Clinical Labor Input update.
The second letter was issued to CMS Administrator Chiquita Brooks-LaSure in response to the 2023 MPFS proposed rule, which sought feedback from stakeholders on the design, sampling and fielding of the Physician Practice Information Survey (PPIS), which informs the Practice Expense methodology and was last updated in 2007. ASTRO joined 11 other specialty groups advocating for transparency and broad stakeholder involvement in the data collection and review process. The letter underscored the importance of including survey questions that would consider the impact of new technologies and differences in practice structures and costs that should be captured to establish an accurate revised practice expense methodology.
ASTRO continues to engage with other specialty groups that are also at risk of experiencing disproportionate payment cuts due to policy shifts within the budget neutral environment. We are also in alignment with the AMA and other groups that are focused on broader reforms to the MPFS, which is proving to be unsustainable over time and in need of reform.