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Proposed Medicare cuts may limit chemotherapy
By Kim Norris, Potentially significant cuts to federal
reimbursements for chemotherapy drugs have some cancer doctors threatening
to stop administering the life-saving medicines in their offices. Proposals in House and Senate versions of
pending Medicare drug legislation are targeting the reimbursements
Medicare pays doctors for close to 100 chemotherapy drugs. The legislation could cut up to $16 billion
of Medicare funding for cancer care over the next 10 years, according to
Congressional Budget Office estimates. In Cancer doctors, who depend on the drug
reimbursements to offset the insufficient payments for administering the
medicines, say reducing the rates could discourage them from giving
treatments in their private practices. Patients would have to go to
hospitals for their chemo treatments. "This system of community care will
cease to exist if these cuts go through," said Dr. David Decker,
director of Cancer Care
Associates, a private oncology practice that employs 60 people on
the campus of Cancer Care Associates hosted a media event
Monday to highlight the consequences the cuts would cause if they go
through. Decker cited an American Society of Clinical
Oncology survey. It indicated 70 percent of private-practice doctors said
they would cease to give chemotherapy in their offices if drug
reimbursements were cut. "Care of these patients will shift to
hospital systems, which already are overburdened," Decker said. Ilene Wolfe, spokeswoman for "We're not here to take business away
from them, but we will provide care to the patients if they no longer
can," she said. Under Medicare, the federally funded health
insurance for 40 million seniors and disabled Americans, hospitals and
doctors are reimbursed differently for outpatient services. At issue are proposals by Medicare that call
for reducing reimbursements to oncologists while increasing the
reimbursements for administrative costs. Drug rates and fees are adjusted
annually. This time, the drug adjustment and fee
adjustment are being presented jointly to reflect where costs are
incurred, said a spokeswoman for the Centers for Medicare and Medicaid. She said the net result to onocolgists is
probably going to be a decrease. "We won't increase the payment rate
as much as we take out of medication," the spokeswoman said. Under the practice-expense increase, Medicare
payments to doctors for the administration of drugs are expected to
increase $1.6 billion over next 10 years. At the same time reimbursements
for drugs are likely to be cut anywhere from $4.1 billion to $27.6 billion
-- depending on which of four proposed rules is adopted. That could
represent a savings of $2.6 billion to $17.6 billion to beneficiaries, who
pay 20 percent of the cost of all Medicare drugs and services. "Everyone agrees that doctors are
overpaid for drugs . . . significantly more than their costs, because of
the way the costs have been determined in the past," the spokeswoman
said. "Our goal is to pay appropriately,"
she said. "When we overpay for a service or drug, the beneficiary
overpays." Copyright
© 2002 Global Action on Aging |
