Serving Cutting

Posted on Friday, June 19th, 2009 at 3:44 am

Serving Cutting

Elders Lose Medicare Cancer Care Coverage Beginning 2010 by Greg Gilbert

I thought it would be informative for those who do not realize the efforts it takes to run a cancer practice, to read one of many efforts put on paper trying to influence those who make decisions about this specialty. It is a constant battle and the following letter demonstrates the current efforts we are working on. If we are unsuccessful "heaven help" patients in the near future.
On behalf of Hematology Oncology Associates, P.C., I submit these comments to the Centers for Medicare & Medicaid Services on the proposed rule for the Medicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B (CY2010) (Document ID CMS-2009-0058-0003). Hematology Oncology Associates, P.C. is a community oncology private practice serving cancer patients in southern Oregon and in northern California.
I am extremely disappointed that CMS has chosen to rely on the flawed AMA survey in making a plan to cut Medical Oncology an additional 6 decrease in overall reimbursement. This statement is very misleading because, in reality, you are reducing reimbursement for our infusion services by over 21, the cuts would be unsustainable and our practice would have to cease providing services to Medicare patients and may have to close.
Since passage of the Medicare Modernization Act of 2003, you have steadily cut reimbursement for cancer care. This is particularly disheartening because your stated goal "to shift reimbursement from drugs to infusion and physician services" was insincere. In fact, you have continued to cut reimbursement in all service areas and have compromised our ability to provide care for seniors.
At present, our "Medicare only" patients cannot receive drug infusion in our office because they have no financial resources for paying the 20% coinsurance and our practice cannot afford to subsidize this shortfall. In addition, the allowables of the current 2009 MPFS fail to cover the costs of providing cancer care services. Of the 75 most commonly used drugs and solutions, Medicare reimbursement fails to cover the cost of 35 of these drugs and solutions. By design, Medicare allowables have never covered the costs for evaluation & management and drug administration services. Implementing the cuts you propose for 2010 will seriously jeopardize our ability to continue treating Medicare patients.
Your proposed increases to evaluation & management services do little to lessen the impact of the cuts to drug administration services, and, in your decision to eliminate consultation services, you are choosing to ignore the value of the Oncologist as a highly trained specialist physician. Rather than revising the onerous and unrealistic coding guidelines for consultative services, CMS is choosing to take an expeditious opportunity to achieve additional reimbursement cuts and insult all specialist physicians in the process.
Since 2003, CMS has steadily dealt community oncology numerous severe blows in the form of reimbursement cuts. The CMS proposal for 2010 will compromise care for seniors and will severely limit access to care. CMS should not implement the cuts to cancer drug administration services and should not eliminate codes for consultative services.

Gregory Gilbert, out of Medford, Oregon, has been in the field of health care for 33 years, and is an administrator of a large Medical Oncology practice. Take control of your "end of life" medical care: additional information on advance directives

Article Source: http://www.earticlesonline.com/Article/Elders-Lose-Medicare-Cancer-Care-Coverage-Beginning-2010/613336