Thoughts From COA

COA Submits Comments to CMS on Proposed 2015 Medicare Physician Fee Schedule

Created on: Tuesday, September 02, 2014

COA President Dr. Bruce Gould submitted comments to CMS on the proposed fee schedule for physicians for 2015. In the letter, Dr. Gould states, "If you look at what is happening in community oncology with payment reform there is much hope going forward, as community oncology is collectively well ahead of academic and institutional-based oncology, as well as other areas of medicine, in implementing payment reform. However, the advances being made are threatened by the continued ratcheting down of Medicare reimbursement for cancer care by CMS, as well as by Congress’ inability...

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Estimate the Impact of the 2015 Proposed Medicare Fee Schedule

Created on: Wednesday, July 30, 2014

COA has released its updated model that allows community oncology practices to estimate the financial impact of the proposed 2015 Medicare Physician Fee Schedule. The model estimates the impact of infusion services and E&M reimbursement changes, as well as those impacting practices with imaging and radiation therapy. You can download a copy of the Excel-based model and can contact Bo Gamble with any problems or questions. CMS is accepting comments on the proposed Medicare Physician Fee Schedule until close of business on September 4, 2014.

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COA Board Approves Position Statement on 340B

Created on: Wednesday, July 23, 2014

The COA Board of Directors developed and released a position statement on the 340B drug discount program. COA Executive Director Ted Okon stated that, “This position on the 340B program took a lot of thoughtful deliberation by the COA Board. The program is a critical safety net for patients in need but it requires modification because it is unsustainable. When the bubble bursts it will be those very patients in need who will be adversely impacted. We hope that all providers and organizations come together proactively to engage in constructive dialogue about strengthening the program to ensure that every...

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CMS Releases Medicare Physician Fee Schedule and Outpatient Proposed Rules

Created on: Sunday, July 06, 2014

CMS released the 2015 Medicare Physician Fee Schedule proposed rule on July 3, 2014 with the proposed rule for outpatient hospital departments. CMS will accept comments on the rules until the end of day on September 2, 2014. COA will have a thorough analysis on the physician rule's impact on community oncology practices. For now, an overview of that rule shows a 1% fee increase for medical oncology, a 2% fee cut to imaging, and a 4% fee cut to radiation therapy. There are other provisions in the rule affecting community oncology. To access a copy of the rule and a fact sheet...

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New COA-Sponsored Study Reveals Shift to 340B Hospitals Increases Costs of Cancer Treatment

Created on: Tuesday, June 10, 2014

The Berkeley Research Group (BRG) released a new study finding that two independent trends, acting in combination, are currently resulting in increased Medicare fee-for-service (FFS) chemotherapy payments. These results reinforce similar findings in previous studies by Avalere Health, Milliman, and The Moran Company. The first trend is a shift in the site of care for cancer patients from physician-owned community cancer clinics to hospital outpatient departments. The second trend is the expansion of the delivery of oncology services by 340B hospitals in recent years through the acquisition of community cancer practices (typically comprising multiple treatment clinic sites).

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New Report Shows Higher Cost of Cancer Care Due to Hospital Consolidation

Created on: Wednesday, May 07, 2014

A new report from the IMS Institute for Healthcare Informatics documents what previous reports from Avalere, Milliman, and Moran have shown – the cost of cancer care is rising with consolidation into hospitals. This latest report finds that “drug administration costs in hospital outpatient facilities are on average an incremental 189% of the level of physician office reimbursed costs for commercially insured patients under the age of 65 years.” The Milliman and Moran studies have documented the higher costs of cancer care for seniors and Medicare when delivered in the hospital outpatient setting.

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COA Issues Statement on Release of Medicare Data

Created on: Thursday, April 10, 2014

COA strongly disagrees with the release of physician-specific Medicare reimbursement claims data and the manner in which the Centers for Medicare & Medicaid Services (CMS) released the data. The data is incomplete, biased, without context, and an unrepresentative sample of Medicare reimbursement to oncologists. Further, CMS did not allow physicians an opportunity to confirm the accuracy of individual data and did not conduct any studies to assess how the data will potentially influence consumers, especially senior beneficiaries, about their medical care decision-making.

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President Signs SGR Patch Bill

Created on: Friday, March 28, 2014

Even though both parties and chambers of Congress have agreed on the policy behind fixing the broken SGR-based Medicare payment system, and actually implementing payment reform, the Congress punted once again. For the 17th time, Congress is avoiding its responsibility and kicking the Medicare can down the road. In a voice vote, so there is no voting record, the House approved a 12-month patch to the SGR. The Senate then voted on the patch bill, passed it, and the President has signed it into law.

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COA and US Oncology Send Letter to Congress to Fix SGR and Stop Cancer Care Crisis

Created on: Friday, March 21, 2014

COA and The US Oncology Network sent a letter to Congress urging them to pass a real fix to the SGR, along with payment reform, while stopping the cancer care crisis. In the letter, signed by COA President Mark Thompson, MD and Barry Brooks, MD, Chairman of the Pharmacy & Therapeutics Committee of The US Oncology Network, the organizations stated that the crisis is documented by a consolidating cancer care landscape that is creating patient access problems, while driving up costs for Medicare and seniors, and by drug shortages plaguing the nation.

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Congress Reaches SGR Deal on Policy; Last Hurdle is Paying for It

Created on: Thursday, February 06, 2014

Congress has reached a deal on the policy of repealing the broken Medicare SGR-based payment system, which will be replaced by comprehensive payment reform. This is a bi-partisan agreement between the House and the Senate. The trick now is for all to agree on how to pay for the bill, which will cost from $125-150 billion over 10 years. Reviewing the section-by-section analysis of the bill, it is very favorable to oncology, especially those practices already working on the Oncology Medical Home. COA will have a more thorough analysis as the bill is finalized.

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