ASCO & CMS News

The following information has been received by ANCO.


****CMS NEWS****
The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.

CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.

CMS will accept comments on the proposed rule until August 31, and will respond to all comments in a final rule to be issued by November 1, 2009. Unless otherwise specified, the new payment rates and policies will apply to services furnished to Medicare beneficiaries on or after January 1, 2010.

To read the entire CMS Press Release issued today (6/30), please click here:
http://www.cms.hhs.gov/apps/media/press_releases.asp

To read the CMS Fact Sheet on the Physician Fee Proposed rule also issued today (6/30), click here:
http://www.cms.hhs.gov/apps/media/fact_sheets.asp

For more information on the proposed rule, which went on display at 11:15 a.m. (approx.) today (7/1) and be published on Monday, July 13. The 60-day comment period will close on Monday, August 31. Click here:
http://www.federalregister.gov/OFRUpload/OFRData/2009-15835_PI.pdf . More information will be posted shortly at: http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/list.asp .


****ASCO NEWS****
CMS just released its proposed physician fee schedule for 2010, and our preliminary review is deeply concerning. An initial analysis of the fee schedule indicates that there could be reductions in overall payments to medical oncologists in the range of 6 percent, with steeper cuts in payments to radiation oncologists upwards of 10 percent.

As you know, AMA conducted a Physician Practice Information (PPI) survey in conjunction with more than 30 medical specialties in order to collect updated data on physician practice expenses per hour. AMA provided this data to CMS earlier this year as the agency developed its physician fee schedule for the coming year.

ASCO had concerns about participating in the survey but ultimately encouraged practices to participate, as the AMA survey is the only mechanism recognized by CMS for calculating the expense of services that oncology practices provide to patients.

According to the AMA, only 50 oncology practices provided data on practice expenses. This is substantially lower than the 245 responses yielded by the 2002 ASCO survey that Gallup conducted and that currently forms the basis for our practice expense payments.

We are certain that your practice expenses have not dropped since 2005, given the high level of the care and treatment that oncologists currently provide people with cancer. In fact, we believe that expenses have more likely increased substantially for many practices. ASCO is prepared to protest this proposed reduction in fee schedule payments in the strongest terms possible. We are already in direct communication with CMS and leaders in Congress to express how critical it is to provide the resources that practices require in order to ensure that all cancer patients receive the care they need.

ASCO will complete a thorough analysis of all provisions in the fee schedule affecting oncology and will provide more detailed information as soon as possible. Contact ASCO's Cancer Policy & Clinical Affairs Department at 571-483-1670 or publicpolicy@asco.org with any immediate questions that you have.