House to HHS: No more cuts to cancer care reimbursement
Eighty-five members of the House have submitted a letter to federal officials calling on them to eliminate additional cuts to cancer care proposed in the 2011 physician fee schedule for Medicare and Medicaid reimbursement.
According to the Community Oncology Alliance, the letter is sponsored by Rep. Steve Israel (D-N.Y.) and was delivered Wednesday to Health and Human Services Secretary Kathleen Sebelius and Centers for Medicare & Medicaid Administrator Donald M. Berwick.
"We have made significant strides in treating cancer in this country and Americans receive better cancer care than anywhere else in the world," said David Eagle, MD, president of the COA and a partner at Lake Norman Hematology Oncology Specialists in Mooresville, N.C. "We commend Representative Israel for his efforts to bring the crisis in cancer care to the attention of other members of the House and use their combined voices to alert HHS and CMS. Community oncology cannot withstand yet another reimbursement cut and continue to deliver cutting edge care; our progress will be lost and patients will suffer if the proposed cuts are implemented."
Since 2004, reimbursement for the administration of chemotherapy has been cut by an estimated 35 percent. According to Ted Okon, executive director of the COA, when taking into account the increased costs of operating a medical practice as measured by the Medical Economic Index, this results in an effective reduction of 47 percent.
A recent study by Avalere Health showed that Medicare covers only 57 percent of the costs of chemotherapy administration.
The CMS has scheduled reimbursement cuts for 2011, 2012 and 2013, at which time Medicare will cover less than half the cost of these cancer care services, according to the COA.
The letter requests that CMS re-evaluate Medicare payment cuts scheduled for 2011 through 2013. The cuts are documented in the proposed 2011 Medicare Physician Fee Schedule, which the CMS is finalizing, COA leaders said.
According to Okon, the cancer-specific cuts will be exacerbated by the 23.5 percent overall Sustainable Growth Rate Medicare reimbursement reduction taking effect Dec. 1 and an additional SGR reduction of 6.5 percent on Jan. 1, 2011.
"COA commends Congressman Israel and the 84 other Representatives supporting cancer care. There is a real crisis escalating as more cancer clinics close and patients fall through the treatment cracks," Eagle said. "The oncology provider community is working hard on enhancements to the quality and efficiency of cancer care, as witnessed by the demonstration project we developed and was included in the healthcare reform law. However, Medicare's unrealistic cuts to cancer care have to stop or the world's best delivery system will be in ruins."
