COA Letter on Medicare Part B Drug Payment Model

Created on: Wednesday, March 09, 2016

Community Oncology Alliance Comments on Medicare Part B Drug Payment Model

An Experiment on Patients; CMS Proposal Sets a Dangerous Precedent

Today, the Community Oncology Alliance (COA) sent a letter to HHS Secretary Burwell and CMS Acting Director Slavitt regarding the recently released CMS Medicare Part B Drug Payment Model.

“The CMS Medicare Part B Drug Payment Model is an inappropriate, potentially dangerous, and perverse experiment on the cancer care of seniors who are covered by Medicare,” says the letter, signed on behalf of the COA Board of Directors by Bruce B. Gould, MD, president of COA and a practicing community oncologist with Northwest Georgia Oncology Centers in Marietta, Ga.

 

Originally announced in an accidental notice to Medicare contractors last month, CMS just released the official proposal for the experiment (link). The proposal – which was rushed through review without physician or patient input – lays out an experiment, not based on quality metrics, that is simply intended to decrease the cost of drugs purchased under the Medicare Part B program. These are drugs administered in the outpatient setting, which include chemotherapy and newer biologics critical to patient care. The CMS Medicare Part B Drug Payment Model intends to drive the selection of cancer drugs towards the CMS definition of “value,” rather than the most appropriate treatment determined by oncologists in close collaboration with their patients.

Over the last week, COA has joined with more than 115 organizations representing patients, providers, advocates, and others in asking CMS not to implement the payment model (see previous letters 1, 2).

“It is an understatement to say that this latest CMS initiative is misguided and a perilous cancer care policy,” says Ted Okon, executive director of COA. “It will only serve to accelerate the consolidation of cancer care into the more expensive hospital setting and undermine the physician-patient collaboration on the treatment of cancer. I thought we were at war on cancer, not cancer care.”

Community oncologists remain committed to having a constructive dialogue with policymakers about these issues. The COA Board of Directors has offered to take time away from patient care at their community practices and meet with HHS/CMS leadership staff as soon as possible. However, COA notes that it is actively pursuing every legal, legislative, and related option on behalf of members to stop the CMS Medicare Part B experiment.

For the sake of all of our patients, we simply cannot let CMS proceed with the dangerous Medicare Part B Drug Payment Model, which is not a true ‘model’ in the CCMI legislative charter but simply another disguised cut to Medicare Part B reimbursement for cancer care. It is very revealing that CMS did not engage any patient and provider stakeholders in developing this perverse experiment, but is now seeking comment at the 11th hour,” says Dr. Gould.

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About Community Oncology Alliance: The Community Oncology Alliance (COA), a non-profit organization, is the leader in advocating for patients and their providers in the community cancer care setting, where almost 70 percent of Americans with cancer are treated. COA leads community cancer clinics in navigating an increasingly challenging environment to provide efficiencies, patient advocacy, and proactive solutions to Congress and policy makers. Learn more at www.CommunityOncology.org

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