Many than 60 cancer care groups sent letters to CMS protesting their proposed alternative payment method for Medicare B drugs, according to Medpage Today.
Here are six takeaways:
1. Some critics claim changing Part B reimbursement to a $16.80 flat payment with an additional 2.5 percent add-on payment will decrease patient access to cancer care.
2. National Patient Advocate Foundation CEO Alan Balch, PhD, claims the proposal will significantly impact patients in rural areas because lowering reimbursement may cause many providers to forgo Medicare patients or refer patients to hospitals.
3. Many patients in rural areas may be forced to travel farther, posing a problem for patients. NPAF reported transportation is a primary concern for more than the 20,000 patients NPAF sees each year, 50 percent of whom are Medicare beneficiaries.
4. A 2012 study found chemotherapy treatment cost in a hospital-owned outpatient office was 34 percent higher than the same treatment in an independent oncology practice.
5. Many opposed to the current reimbursement model say it provides physicians incentives to choose drugs with higher costs. However, Robin Zon, MD, vice president at Indiana-based Michiana Hematology Oncology, claims most oncologists prescribe drugs that are the best for their patients.
6. Community Oncology Alliance has warned it will pursue legal and legislation action to stop the proposal's progress. CAO has an Oncology Care Model that aims to enhance cost, care coordination and quality through performance-based incentives. CAO claims CMS' payment changes are at odds with their Oncology Care Model.
More articles on coding & billing:
HealthCare.gov experiences 300+ security incidents — Are more to come?
Anthem BCBS in Wisconsin names new president: 5 notes
Employers to face higher penalty for not offering health insurance in 2017 — 3 takeaways