COA: Current health reform legislation does not address major inadequacies in Medicare reimbursement

The Community Oncology Alliance (COA) today issued a statement warning that oncologists throughout the U.S. may face closing their practices if critical Medicare reimbursement fixes for treating cancer patients are not made as a part of health care reform.

"Current health reform legislation before Congress does not address major inadequacies in Medicare reimbursement and substantial cuts coming in January to cancer care," said Patrick Cobb, M.D., president of COA and managing partner of Hematology-Oncology Centers of the Northern Rockies in Billings, Montana. "These problems are impacting oncologists now. Many have had to let staff go, and some have already closed practices in communities across the U.S."

"Released this week, the Annual Report to the Nation on the Status of Cancer highlighted the progress made in treating cancer over the past 30 years. This country's cancer care system deserves much of the credit for helping cancer patients receive high quality treatment near home, in their own communities," continued Dr. Cobb. "But this system is under threat if President Obama and Congress do not act before January. These January cuts threaten the viability of the nation's community cancer care delivery system, where 84% of Americans with cancer are treated, and jeopardize patients' access to care."

In separate letters to President Barack Obama, Speaker of the House Nancy Pelosi, and Senate Majority Leader Harry Reid, COA president Dr. Cobb submitted a statement approved by the COA Board of Directors, including a six-part recommendation on solving the cancer care crisis. COA noted that the recent financial crisis has exposed the fragility of the health care payment system, with more Americans unable to afford cancer care and falling between the treatment cracks.

In a national call to action, the organization is encouraging oncology professionals and the entire cancer community to contact Members of Congress to request action on these recommendations, starting with the prevention of planned severe Medicare cuts to cancer care. These cuts start in January and continue to increase over the next four years.

"As a nation, we have watched the health care reform legislation evolve over the past year. One issue we have not heard much about -- and not through lack of trying -- is legislation for the reform of cancer care," continued Dr. Cobb. "Although there are certain positive aspects of reform relating to insurance coverage, the proposed legislation comes up woefully short in addressing a growing cancer care crisis."

Prior to Congress embarking on health reform legislation, a national team of oncologists spent more than a year researching and developing a plan to improve the Medicare payment system for cancer care. This initiative resulted in collaborating with members of Congress, now embodied in the National Cancer Care Demonstration Project Act of 2009 (H.R. 3675).

Dr. Cobb noted, "Because of the timing of the health care reform debate, we're concerned that progress in funding and implementing this very specific national project is too slow to stop the impact of the upcoming January cuts."

The organization has issued a six-part recommendation, which includes immediate action:

1. Enact real-world solutions to enhancing quality cancer care while controlling costs by including the National Cancer Care Demonstration Project Act of 2009 (H.R. 3675) in health care reform legislation.
2. Stop implementation of Medicare reimbursement cuts to cancer care, especially the payment reduction to cancer drug administration.
3. Stop the 2010 21.2% Medicare reimbursement payment cut affecting all physician-related services and fix the broken Medicare payment system based on the SGR formula.
4. Stop cutting cancer care reimbursement further by using cuts to pay for primary care bonuses.
5. Fix the problem of artificially low Medicare drug reimbursement by including the "prompt pay" solution in health care reform legislation.
6. Eliminate the 20% Medicare patient co-payment requirement for cancer drugs.

A full statement is listed the organization's web site (www.communityoncology.org).

"The War on Cancer, declared almost 40 years ago, has resulted in increased survival for Americans with cancer and has transformed many cancers from a death sentence to a chronic disease," continued Dr. Cobb. "However, the cost of cancer is still in excess of $220 billion annually and it claims the life of one American every minute. Congress must act now as health care reform legislation is being debated because the risk of getting this wrong is too great, both as measured in medical costs and the lives of Americans."