Head of Medicare and Medicaid Describes Newly Proposed Plan to Lower Costs and Improve Care
April 5th 2011Donald M. Berwick, the Director of Centers for Medicare and Medicaid Services (CMS) of the Health and Human Services Department as of March 2010, has written a perspective on the accountable care organizations (ACOs) of the Medicare Shares Savings Program.
Oncology Care in 2021: The FDA, Medicare, and Healthcare Reform
March 29th 2011At the Association for Community Cancer Centers annual national meeting in Washington, DC this past March, the session on “Oncology Care in 2021” featured three panelists with significant experience in shaping healthcare policy.
CMS: Provenge shows evidence of ‘moderate’ benefit
December 29th 2010The prostate cancer drug Provenge (sipuleucel-T) offers a moderate survival benefit to patients, according to an analysis performed by the U.S. Centers for Medicare and Medicaid Services. The analysis was undertaken as part of a CMS review initiated in July to determine whether to cover the cost of the therapy.
Dendreon vs CMS: Why the Provenge Coverage Controversy Is Bigger Than Just One Product
September 22nd 2010It appeared that the controversy surrounding the prostate cancer immunotherapy Provenge ended with FDA approval in April. But now Medicare is questioning whether the government should pay for the new therapy. The CMS decision is just as important to the biopharmaceutical industry as it is to Dendreon.
Community Ocology Alliance (COA) urges HHS sec Sebelius to stop cancer care cuts
September 1st 2010Community cancer clinics, which treat more than 75% of all cancer patients, are struggling with Medicare reimbursement. Cuts in the Proposed 2011 Medicare Physician Fee Schedule will a have devastating effect on the delivery of cancer care. COA is calling for action.
HHS sec tries new idea; to what end?
August 16th 2010Did you know there is going to be a Center for Medicare and Medicaid Innovation? The authority comes from the new health reform law. And it appears to give the Health and Human Services Secretary enormous discretion to try almost any new idea she finds interesting.
UNPRECEDENTED: Medicare Chief Actuary disavows Medicare Trustees Report
August 11th 2010For the first time in Medicare history, the Medicare Chief Actuary has called the projections in a Medicare Trustees Report “unreasonable” and “implausible” and encouraged everyone to ignore them and view instead an “Illustrative Alternative” report.
CMS vs the Compassionate Access Act
July 28th 2010Medicare is now questioning whether the government should pay for new therapy's such as Provenge. The CMS decision is just as important to the biopharmaceutical industry, doctors, and their patients as it is to Dendreon. H. R. 4732, The Compassionate Access Act, calls to give access to novel drugs;will CMS serve as a roadblock?
CMS urges payment delay to defend physician payments
March 1st 2010It’s a kind of man bites dog story: unusual, remarkable, yet oddly plausible. The Centers for Medicare and Medicaid Services has told its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule for the first 10 business days of March.
Fighting a Smarter War on Cancer
February 11th 2010In my practice as an oncologist specializing in gastrointestinal tract cancers, a recent week was fairly typical. I saw 50 patients, ranging in age from 32 to 87, equally divided between men and women. Though a couple of them have inherited a gene that may have caused their GI cancers, I have no explanation for why most developed their disease. It is as if they were simply struck by lightning.
CMS nixes CT colonography screening
June 19th 2009Bucking the tide of medical professional opinion, CMS decided against granting payment for CT colonography as a screening test for colorectal cancer. CMS ruled that the clinical evidence remains inadequate to conclude that CTC is appropriate for that role.
Minority groups protest CMS’ rejection of VC screening
April 24th 2009Members of the Congressional Black Caucus have joined the ranks of virtual colonoscopy (VC or CT colonography [CTC]) advocates to pressure the Centers for Medicare and Medicaid Services to reverse a proposal to deny reimbursement for VC screening. Proponents argue that the policy could widen existing colon cancer screening inequalities.
Calculate, negotiate: Pay heed to your non-CMS fees
March 20th 2009Physicians regularly miscalculate their non- Medicare fees, which means that revenue is slipping away. Have you reviewed your fee schedules lately to determine if you’re getting proper reimbursement for all your services? Now is a great time to take a look and make appropriate changes for 2009. Here are some steps to determine if private payers are reimbursing you at a fair rate.
Cancer luminary lambasts slow-moving U.S. clinical trials
February 25th 2009The clinical trials program in the U.S. is broken and apparently nobody has noticed,” Vincent T. DeVita, Jr., MD, wrote in a recent editorial in Nature Clinical Practice Oncology (5:683, 2008), of which he is editor-in-chief.
Clear communication saves patients from emotional limbo
January 2nd 2009Oncologists face special patient communication challenges, as cancer treatments are highly complex and prognosis is often grim. For various reasons, important information is often avoided or communicated poorly, leaving cancer patients in emotional limbo.
Infusion confusion: Quick fixes for keeping reimbursement on track
November 1st 2008In January 2005, Medicare changed the coding and billing of injection and infusion services in order to describe more precisely the complexity of the services and provide adequate reimbursement for the nursing time involved.
Oncology electronic health records: More than just an e-secretary
October 1st 2008Electronic health records can help oncology practices save money and work smarter. Then why has the adoption of e-technology been so frustratingly slow? A recent survey in the New England Journal of Medicine found that only 4% of physicians reported having a fully functional electronic health record (EHR) system; only 13% reported having a basic system (NEJM 359: 50-60, 2008).