News | July 20, 2012

ASTRO Criticizes Proposed Drops in Reimbursement for IMRT, SBRT

July 20, 2012 — On July 6, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would revise several reimbursement payment policies and rates for services furnished under the Medicare Physician Fee Schedule (MPFS) as of January 1, 2013. The proposed changes reflect an overall 15 percent reduction in payment for radiation oncology services, equaling a $300 million loss for the provision of cancer care services, according to the American Society for Radiation Oncology (ASTRO). The most significant portion of the cut, 7 percent, is due to a change by CMS in the treatment times for IMRT (intensity-modulated radiation therapy) and SBRT (stereotactic body radiation therapy) procedure codes.  

“These cuts would have a negative impact on patient access to life-saving cancer treatment, particularly in rural communities, and could jeopardize patient safety,” said Leonard L. Gunderson, M.D., M.S., FASTRO, chairman of ASTRO’s board of directors. “ASTRO believes that CMS should utilize the rigorous processes and methodologies already in place and utilized for the past 20 years to set reimbursement rates. ASTRO supports the American Medical Association’s (AMA) RUC process as the most appropriate process to value practice expenses, and ASTRO welcomes the opportunity for a comprehensive review of treatment costs. The proposed cuts to radiation oncology reimbursement are more than double what has been proposed for any other healthcare providers. It is essential to protect and to strengthen access to safe cancer care nationwide. 

“Radiation oncology is an important tool in the fight against cancer. Radiation therapy is a safe treatment option with a long track record of effectively treating cancer with minimal side effects. In the last 25 years, the survival rate for many cancer patients has increased steadily. For example, in the mid-1970s, the five-year survival rate for breast cancer was 75 percent; for prostate cancer it was 69 percent. Today, the five-year survival rate is 90 percent for breast cancer and 99 percent for prostate cancer. Decreased access to care will reverse the significant and continued progress in patient survival.”

Preliminary results from ASTRO’s member survey indicate that these cuts could affect many practices, particularly in rural communities. Initial survey responses reveal that practices may be forced to close their doors, delay or not purchase new equipment, lay off staff, as well as limiting and/or not accepting Medicare patients.  

An urban radiation oncology practice in Nevada reports, “Every year we do more and more with less. Even a 10 percent cut would be devastating for our patients, staff and community. We would need to let employees go, which would be devastating for our economy, and our patients would suffer with decreased access to life-saving cancer care.” 

“These cuts would severely limit our ability to provide quality care to patients close to their homes. We will not be able to sustain staff levels or maintain technology required for high-quality care,” said a rural Texas radiation oncologist.  

For more information:

Related Content

SpaceOAR Hydrogel Now Available in Japan
News | Patient Positioning Radiation Therapy | July 16, 2018
Augmenix K.K. announced that SpaceOAR hydrogel, a soft, implanted absorbable gel spacer is now available to all...
RaySearch Releases New Version of RayCare OIS
Technology | Oncology Information Management Systems (OIMS) | July 13, 2018
RaySearch has released RayCare 2A, the latest version of its flagship oncology information system (OIS). RayCare is...
Lack of Insurance Coverage Delaying Proton Therapy Clinical Trials
News | Proton Therapy | July 12, 2018
Randomized clinical trials are the gold standard of cancer research and can shed light on whether innovative, new...
Bruce Power Joins Forces With ITM to Supply Lutetium-177 for Cancer Therapy
News | Radiation Therapy | July 11, 2018
Canadian nuclear power company Bruce Power and German-based Isotope Technologies Garching (ITG) signed an agreement to...
MedStar Georgetown University Hospital Now Clinical With RayStation and Hyperscan
News | Treatment Planning | July 05, 2018
MedStar Georgetown University Hospital in Washington D.C., has begun patient treatments using the RayStation treatment...
Northern Centre for Cancer Care (NCCC)

Northern Centre for Cancer Care (NCCC).

Sponsored Content | Case Study | Radiation Therapy | July 05, 2018
Established in 2009, Northern Centre for Cancer Care (NCCC) is the largest center of its kind in the north of England....
Feature | Proton Therapy | July 03, 2018 | By Jeff Zagoudis
The Alliance for Proton Therapy Access (APTA) released a national report in late May revealing the heavy emotional and...
Researcher Investigates Eliminating Radiation for HER2-Positive Breast Cancer
News | Radiation Therapy | July 02, 2018
Researchers at The University of Kansas Cancer Center have launched a clinical trial that eliminates radiation from the...
New Prostate Cancer Radiotherapy Technique Aims to Preserve Sexual Function
News | Radiation Therapy | June 18, 2018
A multicenter clinical trial being led by UT Southwestern physicians is testing a technique for sparing nerve bundles...
Elekta Unity High-Field MR-Linac Receives CE Mark
News | Image Guided Radiation Therapy (IGRT) | June 18, 2018
Elekta announced that its Elekta Unity magnetic resonance radiation therapy (MR/RT) system has received CE mark,...
Overlay Init