Regulations Would Dramatically Affect Radiation Oncology
The last two ACRO Alerts have addressed aspects of the proposed cuts in the Medicare fee schedule for radiation oncology services. There are a few days remaining if you wish to help in this effort. Read below and feel free to use the pre-written draft letters to make your voice heard.
Congressional Support:
ACRO appreciates the support of Reps. Lois Capps (D-Calif.), Sue Myrick (R-N.C.), Mike Rogers (R-Mich.) and Parker Griffith, M.D. (D-Ala.) and over 60 other Members of Congress for their leadership by sponsoring a letter to CMS on this issue. The letter is available by clicking here. In the Senate, Sens. Lincoln and Burr also have organized a sign-on letter to CMS on the issue, please click here to see the letter from the senators.
ACRO encourages its membership to contact their Senators and ask them to sign the Lincoln/Burr letter before the new September 15 deadline.
Proposed Cuts:
Recently, CMS released its proposed physician reimbursement rule for 2010. Several components of the CMS proposal would dramatically reduce reimbursement for radiation oncologists. ACRO believes that such drastic changes would seriously destabilize the foundation of radiation cancer care.
The substantial reductions in revenue would likely mean that many individuals and facilities could not continue to provide services. ACRO is deeply concerned that patients would experience delays in care and radiation oncologists would be challenged to provide the personalized medical care that each patient expects. To understand the potential reductions here are the reimbursement changes for just a few key radiation oncology codes:
CPT® 55875 - placement of needles into prostate decreases 35%
CPT® 77014 - CT guidance decreases 32%
CPT® 77336 - physics consult decreases 43%
CPT® 77413 - treatment delivery decreases 14%
CPT® 77414 - treatment delivery decreases 16%
CPT® 77418 - IMRT decreases 44%
CPT® 77421 - stereoscopic guidance decreases 19%
CPT® 77786 - remote afterload HDR decreases 26%
These devastating effects are a result of the following changes proposed by CMS:
Increasing the equipment utilization rate from 50% to 90%. CMS estimates that this results in an overall reduction of 5% for radiation oncology; however, the impact on specific codes is far greater. CMS has proposed to treat therapeutic equipment costing over $1million in the same way as diagnostic radiology equipment.
Updating practice expense data from recent surveys without sharing the data, allowing adequate time to review the full impact of the change and substantially destabilizing radiation oncology revenue as a result. CMS has not used a transparent process that allows specialties to review the information and determine whether standard data precision requirements are in place. The data changes do not adequately capture the resources needed to provide patient care and is contrary to CMS's own policy of using a methodology that appropriate reflects practice expenses. CMS estimates that using the new data reduces overall payments to radiation oncology by 12%. Again, the impact on specific codes can be far greater.
Reducing the conversion factor as mandated by statute. Absent any last-minute intervention by Congress, the conversion factor is expected to drop by 21%. from $36.06 to $28.32 This reduction would be in addition to the cuts mentioned above.
Click here for a detailed summary of the legislation, which is available on ACRO.org.
What You Need to Do:
ACRO continues to represent the interests of ACRO Members meeting directly with members of Congress and with CMS. However, we need your immediate help and your participation is vital. ACRO is asking that each member IMMEDIATELY do the following:
· Write a letter to CMS objecting to the proposed regulations using either a personalized letter or the general letter ACRO has developed. Click here for sample letters.
· Write your Congressman using either a personalized letter or the general letter ACRO has developed both sample letters are available by clicking here.
· Call your Congressman and share your concerns. This step is especially critical for radiation oncologists who have any personal relationship with members of Congress. Congress is currently on its August recess, so many members are available in their home districts for personal face-to-face meetings
· Work with the allied health professionals in your organization and urge them to contact their professional associations as well as write their congressmen. Cuts such as those currently proposed are unsustainable and will impact jobs.
Get your Patients Involved:
Interested cancer patients may find sample patient letters by clicking here.
We will continue to work on behalf of the radiation oncology community and appreciate your time and attention to this matter.
Sincerely,
Michael Kuettel, MD, PhD, FACRO, President
Michael Kerley, MD, FACRO, President-Elect
Paul Wallner, DO, FACRO, Chair, Economics Committee
Arve Gillette, MD, FACRO, Chair, Government Relations Committee
