No Cut to Radiation Therapy in Medicare Physician Fee Schedule Final Rule, Future Uncertainty Persists
December 9, 2013
Contact: Rebecca Reid

No Cut to Radiation Therapy in Medicare Physician Fee Schedule Final Rule, Future Uncertainty Persists

Radiation therapy leaders call for comprehensive payment reform to improve the quality of care for life-saving cancer care

WASHINGTON – The Radiation Therapy Alliance (RTA) – a nonprofit organization representing 227 community-based radiation therapy centers – today commended the Centers for Medicare and Medicaid Services (CMS) for withdrawing the proposal to cap certain freestanding radiation oncology reimbursements at the OPD/ASC rates in the CY 2014 Physician Fee Schedule Final Rule, issued November 27. While the Proposed Rule would have reduced payments by nearly 8%, the final rule is close to no change (relative to 2013) for free-standing radiation oncology providers.

While radiation therapy leaders commended CMS’ decision to remove the proposed cap from the Final Rule, they cautioned policymakers that the continued uncertainty in Medicare radiation therapy payments threatens the delivery of freestanding radiation oncology services for American seniors. The RTA called on Congress to advance comprehensive Medicare payment reforms for freestanding radiation services.

Over the last decade, payments to freestanding radiation therapy centers have declined by 18 percent. Since 2004, freestanding radiation therapy centers have experienced disproportionate cuts compared to hospital-based radiation therapy, which has experienced a net increase in reimbursement during the same period.

“While we appreciate the final outcome in the Physician Fee Schedule, the rulemaking process once again reminds us of the need to provide stability and security to the millions of Americans receiving and providing cancer care,” said Dr. Christopher Rose, a practicing radiation oncologist, cofounder of Vantage Oncology, and chair of the Radiation Therapy Alliance Policy Committee. “Considering the history of cuts and uncertainty our cancer care community has endured, it is time for lawmakers to correct unresolved payment issues and consider systematic reforms that protect patients and ensure payment stability for the radiation oncology provider community – so that we can offer the highest quality care to patients.”

Radiation oncology leaders are further urging Congress to establish an episode-based bundled payment for freestanding radiation oncology to promote the highest quality of care by improving incentives for physicians, collecting data to improve protocols, and ensuring payment stability. A bundled payment model will generate savings for taxpayers, increase predictability for providers, and produce better clinical outcomes for patients over time.

“We have an opportunity to replace Medicare’s unstable cancer delivery system with one that promotes quality care, benefits patients, and reduces Medicare spending,” added Dr. Rose. “As Congress works to avoid a drastic cut to the Sustainable Growth Rate and reform that payment structure, we hope they will adopt an episode-based bundled payment system for freestanding radiation therapy.”