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For Immediate Release: September 30, 2005
Physician Offices Face Another Round of Steep Payment Cuts Under 2006 Medicare Proposed Fee Schedule
Association of Community Cancer Centers Concerned About its Impact on Quality Patient Care
ROCKVILLE, Md.—Medicare beneficiaries’ access to quality cancer care could suffer immensely from payment cuts proposed in the 2006 Medicare Physician Fee Schedule (PFS), according to the Association of Community Cancer Centers' (ACCC) official comments submitted to the Centers for Medicare and Medicaid Services (CMS) on September 30, 2005. The proposed cuts, combined with the ongoing payment reforms spurred by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), could create significant obstacles for cancer patients and their physicians in 2006.
CMS forecasts that changes in the 2006 fee schedule will reduce Medicare payments for hematology and oncology services by 5.6 percent. The cuts in payment for drug administration services are even deeper, ranging from 6 to 7 percent.
"These cuts alone could create access problems, but when combined with proposed cuts in hospitals' reimbursement for drugs and their administration services, the effects could be disastrous," according to Edward Braud, MD, chair of ACCC’s Governmental Affairs Committee and a practicing physician in Springfield, Ill.
With hospitals possibly reducing or eliminating their cancer programs in the face of similar levels of payment cuts, the proposed reductions in the proposed 2006 PFS come at a time when physicians may be confronted with increased volumes of patients and greater challenges to providing quality patient care.
"We are now aware of hospitals that have reduced or eliminated their outpatient services, leaving some patients to seek care in physician offices and other patients, who need treatments that are available only in hospitals, with nowhere to turn," Dr. Braud added.
Deborah Walter, ACCC senior director of policy and government affairs expressed her concern that "the proposed payment reductions to physicians could have grave implications for patients battling cancer."
"Many of our members simply cannot absorb the significant cuts in payment rates for cancer services without substantial ramifications for patient care," she added. Walter hopes that CMS will carefully consider a number of recommendations that could mitigate this problem.
ACCC recommends that CMS revise the sustainable growth rate formula as needed to prevent the expected 4.3 percent cut in the conversion factor and review the practice expense relative value units (RVUs) for drug administration services as soon as the necessary data are available to ensure that these RVUs accurately reflect all of the costs associated with administration of advanced drug therapies. ACCC also looks forward to working with CMS to identify appropriate quality measures and payment incentives that will promote the delivery of high quality, patient-centered cancer care.