2010 PROPOSED MEDICARE PHYSICIAN FEE
SCHEDULE -
DRAMATIC IMPACTS FOR RADIATION ONCOLOGY
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 network of radiation cancer
care. The substantial reductions in revenue would
likely mean that many 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 would
expect. To understand the potential reductions here are the
reimbursement changes for just a few key radiation oncology
codes
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%
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 equipment.
-Updating practice expense data from recent
surveys without openly 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
statue. Absent any last minute intervention by
Congress, the conversion factor is expected to drop by 21%.
This reduction would be in addition to the cuts mentioned
above.
A detailed summary of the legislation is available by clicking here.
ACRO continues to represent the interests of
radiation oncologists 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 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 (Sample Letters #1 and #2
are available by clicking here).
-Write your Representative and Senators using either a
personalized letter or the general letter ACRO has developed
(Sample Letters #3 and #4 are available by clicking here along with a link to help
you locate the name and address of your Congressman).
-Call your Representative and Senators and share your
concerns
-Provide sample letters to your patients so that they may
express their concerns (Sample Patient Letter #5 is
available by clicking here)
-Work with the allied health professionals in your
organization and urge them to contact their professional
association as well as write their congressman. Cuts such as
those currently proposed are unsustainable and will impact
jobs.
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, President
Michael Kerley, MD, President-Elect
Paul Wallner, DO, Chair, Economics Committee
Arve Gillette, MD, Chair, Governmental Affairs Committee
|
