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Cancer doctors fault Medicare bills

 By Nicole Foy

Express-News Medical, July 18, 2003

 A move in Congress to slash Medicare payments for cancer treatments administered outside of hospitals could severely limit patient access to care, some oncologists warn.

The measure could force some doctors to turn away seniors with cancer, causing them to seek treatment at hospitals instead, charged Dr. Lon Smith, president of South Texas Oncology and Hematology, a local physician group.

It also could mean cancer care clinics, in an attempt to save money and stay in business, would close their doors completely or choose to forgo newer, more expensive drugs for less costly options, he said.

"The cuts in this bill will drastically reduce access to the treatment patients currently receive in doctors' offices across the country," he said.

Supporters of the cuts say the savings would help relieve the burden on Medicare patients who pay for overpriced drugs.

According to the American Society of Clinical Oncology, the House and Senate bills establishing prescription drug coverage under Medicare would cut more than $500 million — 30 percent — annually from cancer care in outpatient offices.

Medicare officials say the current system grossly overcompensates physicians for treatment services by basing payment on the average wholesale price of the drugs — a formula based on pharmaceutical industry price reports. Government estimates have reported drug overpayments at about $1 billion annually.

Although oncologists acknowledge the system is flawed, they stress it is set up that way to subsidize essential services that go unfunded.

For instance, Medicare currently does not reimburse physicians' offices for administering drugs to cancer patients, so the drug overpayments go toward that cost, they say.

Although both versions of the bill would provide funding for those services, many in the cancer care community say the language is too vague or the provisions aren't enough.

Hundreds of oncologists, including many from San Antonio, were in Washington this week to ask lawmakers to reconsider the potential cuts.

Bills passed the House and Senate last month, and a conference committee now is working on ironing out the differences.

Dr. Allison Garner, another oncologist, said the House version under consideration would force doctors to go through a vendor for drugs, making the system more cumbersome.

U.S. Rep. Charlie Gonzalez, D-San Antonio, said he wants a better system to adequately cover all oncologists' costs of caring for seniors with cancer. He criticized the current language of the House and Senate bills.

"You'd think there'd be some sort of logic to it, but it's all about money," he said. "The logic is simply to get it down to the least cost."

Gonzalez is having a town hall meeting on the issue at 10 a.m. Saturday at the Cancer Therapy and Research Center, 7979 Wurzbach Road, in the Grossman Building.


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