Senate and House working on passing bills that can be merged into final health care reform legislation. The next 4-8 weeks are critical.
Senate and House working on passing bills that can be merged into final health care reform legislation. The next 4-8 weeks are critical. www.communityoncology.org under Immediate Action Needed.
Severe Medicare cuts planned for 1/1/2010 unless Congress pressures CMS to reconsider these cuts.
Please engage your Members of Congress by sending a letter to your Senators and Representatives signed by all of the community oncologists in the state. A show of unity and single message is key.
Details on the COA website at
The two big fronts impacting community oncology are health care reform legislation and the pending reimbursement cuts to Medicare. It is critical that you understand the implications of both and be engaged with your Members of Congress on both. Here is a brief review of the major points of both.
Where is Health Care Reform Legislation Going?
The Senate Finance Committee is trying to push through its version of a health care reform bill by the end of this week. The next step is for the Senate to merge the bill already passed by the Health, Education, Labor & Pensions Committee with that of the one coming out of the Finance Committee. The Finance version will be the version worked off of in crafting a final bill that the entire Senate can vote on, most likely in several weeks. It is expected that among the provisions impacting community oncology will be a patch to the Medicare Physician Fee Schedule, which will avert the scheduled 21.5% payment cut for 2010, but will leave another cut looming for 2011. Additionally, there will be cuts to diagnostic imaging, although these are expected to be less severe than those proposed by the Centers for Medicare & Medicaid Services (CMS). There are several other provisions of note that have broad, transformative implications. One will be to create an independent board involved in making changes to Medicare reimbursement. The others will set in motion the fundamental revamping of the Medicare payment system, which will involve care coordination, bundling of services, and quality-based payment.
Before the Senate votes on a final bill, the liberal Democrats will do everything possible to push through a public plan option. Senators Rockefeller (D-WV) and Schumer (D-NY) tried and failed to include a public plan option in the Senate Finance bill. They now vow to take that fight to the Senate floor. Most liberals favor creating a government-run insurance plan that is based on Medicare rates. However, more Members understand that a public plan based on Medicare would be unworkable, especially in the area of cancer care. Clearly, the Community Oncology Alliance (COA) has been communicating a clear message that Medicare is a broken system when it comes to cancer care.
The House is keeping one eye on the Senate while merging the three committee bills already passed into one final bill that the House can vote on in coming weeks. The House bill may end up going further than the Senate version in actually trying to fix the Medicare Physician Fee Schedule by rebasing the Sustainable Growth Rate. Other than that, the House bill will contain imaging cuts and measures to transform the Medicare payment system. The real problem in the House is that there is an intense debate among Democrats on the public plan option. Liberals are vowing not to vote for a bill that excludes the public plan; conservative Democrats are saying they will not vote for a bill with a public plan option, especially one that is based on Medicare rates.
In terms of specific provisions positive for community oncology, the solution to the prompt pay problem is contained in the Energy & Commerce version of health care reform. COA is working hard with the community to make sure this stays in the House bill and is included in the final bill when House and Senate versions are merged. Language on the National Quality Cancer Care Demonstration Project is included in the Senate bill and COA is working hard to retain this language in the final health care reform legislation.
What is the Status of the Medicare Cuts to Oncology?
CMS has received over 11,000 comments on the Medicare Physician Fee Schedule. These include the comments submitted by COA, other cancer organizations, and individual practices. In an upcoming email of Thursday this week, a group of oncology practice administrators will relate their experiences in meeting with CMS several weeks ago. The bottom line is that unless CMS gets pressure from the Congress to reconsider the cuts to oncology, effective January 1, 2010 there will be reimbursement reductions to drug administration, consultation services, diagnostic imaging, and therapeutic radiation. COA is working hard with Members of Congress to call their attention to these cuts and get their support to urge CMS to forestall its plans.
Several states including Connecticut, Ohio, Kentucky, Oklahoma, and Louisiana have sent letters to all of their Representatives and Senators, signed by the community oncologists, urging Congress to help stop the Medicare cuts to cancer care and to fight for provisions in health care reform legislation.
Senate and House working on passing bills that can be merged into final health care reform legislation. The next 4-8 weeks are critical.
Severe Medicare cuts planned for 1/1/2010 unless Congress pressures CMS to reconsider these cuts.
Please engage your Members of Congress by sending a letter to your Senators and Representatives signed by all of the community oncologists in the state. A show of unity and single message is key.
Details on the COA website at www.communityoncology.org under Immediate Action Needed.
We urge every state to get involved in sending letters. Go to the COA website at www.communityoncology.org under the Immediate Action Center for details. In addition to information on how to generate these letters, with help from COA, is Late Breaking News and other information tailored for community oncology. This includes a new patient advocacy network section of the website. Check it out today!
These cuts are serious and severe. A top priority for every community oncology practice should be to stop CMS from making these cuts to Medicare. Please get involved by engaging your Members of Congress to get their support.
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