On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2010 physician fee schedule that includes a 1% reduction for oncology services for 2010. Oncology will still be subject to a 6% total cut that will be phased in over 4 years. This is less drastic than the 6% cut for 2010 that CMS included in its proposed fee schedule. However, the American Society of Clinical Oncology (ASCO) stated that it is concerned about any cuts to oncology and will be working to mitigate those cuts in the coming months. ASCO sent out a Member Alert November 4, highlighting key components of the fee schedule that affect oncology practices.
Praise From ASTRO
The American Society for Radiation Oncology (ASTRO) praised CMS for limiting the payment reductions initially proposed for radiation oncology and spreading the remaining cuts over 4 years. ASTRO had asked CMS to not implement proposed changes to the Medicare policies and payment rates for physician services that would have cut radiation oncology services by 19%, with certain services being cut by up to 44%. An ASTRO survey conducted in July indicated cuts of this scale would have a particularly devastating effect on community-based cancer centers and the patients they treat. The final rule is slated to reduce radiation oncology payments by only 5% over a 4-year period, or only about a 1% cut for 2010.
“CMS’s important action will allow radiation oncologists, particularly those working in community-based practices, to continue providing lifesaving radiation treatments for cancer patients. Keeping these clinics open and continuing to see Medicare beneficiaries with cancer will ensure cancer patients have local access to their essential daily treatments,” ASTRO Chair Patricia Eifel, MD, FASTRO, a radiation oncologist at M.D. Anderson Cancer Center in Houston, said.
Criticism From COA
The Community Oncology Alliance (COA) criticized the newest round of cuts in cancer care as a move in the wrong direction of health-care reform. Although not as devastating as expected, the cuts by CMS will still decrease reimbursements far beyond what the US cancer care delivery system, including most patients, can bear, according to COA.
“Oncologists have endured substantial Medicare payment reductions since 2004,” said Patrick Cobb, MD, president of COA and managing partner of Hematology-Oncology Center of the Northern Rockies in Billings, Montana. “Some practices will not survive even lower reimbursements again next year. This will limit the availability of care and the access to care, ultimately jeopardizing patient well-being. This most recent round of cuts is the first step to a slow death for cancer practices and to access problems for our patients.”