CMS Cuts in Medicare Reimbursement Due to Rampant Inflation, COVID, Sequestration and Reconciliation Pricing Reform Are a Major Threat to Cancer Care
— Ted Okon, Director of Aviation
WASHINGTON, DC, USA, July 8, 2022 /EINPresswire.com/ — Statement by Ted Okon, Executive Director, COA
Medicare’s Proposed Physician Fee Schedule for Calendar Year 2023 (CY2023) released by the Centers for Medicare & Medicaid Services (CMS) is another in a series of relentless and senseless payment cuts the agency has made. to community oncology practices. CMS proposed a 4.42% reduction in the Medicare conversion factor along with additional reductions in oncology, imaging and radiation therapy.
The result of CMS cuts in Medicare reimbursement has been well documented as closing cancer clinics and forcing treatment into the most expensive hospital setting. To add insult to injury, these latest cuts come in the face of historic inflation, new strains of COVID, the return of the receivership cut, and drug price reform in the government’s reconciliation bill. Senate that puts suppliers in the middle of negotiations between the government and drugmakers. This poses a major and unprecedented threat to our nation’s cancer care system.
The proposed fee schedule also comes as Senate Democrats and the Biden administration advance prescription drug pricing reform provisions in the reconciliation bill that implement negotiation of drug prices in such way that community oncology practices, as well as other specialized medical practices dealing with serious illnesses, will face unbearable financial risk. Indeed, according to the current wording, practices will be reimbursed at much lower negotiated rates relative to the underlying drug costs.
The COA has repeatedly and correctly predicted that the sharp cut in Medicare payments will lead to cancer practice closures and consolidations. As reimbursement has steadily declined over the past two decades, chemotherapy administered by independent community oncology practices has decreased by 64.3%. In subsequent years, 1,748 community oncology clinics and/or practices closed, were acquired by hospitals, were subject to corporate mergers, or reported experiencing financial difficulties.
When independent practices close, care is almost always moved to the much more expensive and less convenient hospital service site. Studies have consistently shown that hospitals charge patients, insurers and taxpayers far more for cancer treatment and care. In addition, access to care is threatened by the closure of cancer clinics and other specialized institutions, especially in rural areas, due to financial pressures.
When will CMS realize the folly of its ways? Insane payment cuts have only succeeded in driving up Medicare spending as hospitals consolidate medicine and rule the roost. It’s time for Congress to stand up and do the right thing to protect community oncology providers.
About the Community Oncology Alliance: The Community Oncology Alliance (COA) is a nonprofit organization dedicated to advocating for community oncology practices and, more importantly, the patients they serve. COA is the only organization dedicated solely to community oncology where the majority of Americans with cancer are treated. The CCO’s mission is to ensure that cancer patients receive quality, affordable and accessible cancer care in their own community. More than 1.5 million people in the United States are diagnosed with cancer each year, and deaths from the disease have steadily declined due to earlier detection, diagnosis, and treatment. Learn more about COA at communityoncology.org.
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