The Association of Community Cancer Centers (ACCC) has expressed concern about the Centers for Medicare & Medicaid Services (CMS) proposed changes to the work relative value units (RVUs) under the physician fee schedule, and to the practice expense methodology. These were published in the Federal Register on June 29, 2006 and covered in Practice Manager Insider on July 5. They are scheduled to take effect on January 1, 2007 and would be phased in over 4 years.
ACCC expressed concern that the proposals would reduce beneficiary access to quality cancer care. It recommended that CMS:
Postpone any changes to the RVUs that would reduce reimbursement for drug administration services, including administration of radioimmunotherapies, until CMS can ensure that beneficiary access to care will not be reduced. The proposed method for calculating practice expense RVUs would reduce RVUs for many drug administration services by 2% to 8% in 2007, according to ACCC. When fully implemented, RVUs for many drug administration services would fall by 4% to 33%.
Postpone reductions to RVUs for imaging services until CMS has measured effects of the payment decrease for certain multiple imaging services. CMS in 2006 reduced payment for the technical component of multiple imaging procedures on contiguous body parts by 25%. It also has separately proposed limiting payment for multiple imaging procedures to the amount paid when those services are performed in hospital outpatient departments.
Finalize the proposed work RVUs for radiation oncology services, delay changes in assumptions regarding equipment utilization, and review the proposed practice expense RVUs for medical physics services in radiation oncology. ACCC notes that CMS has proposed reducing practice expense RVUs drastically for medical physicists’ services – eg, by nearly 77% over 3 years in the case of the CPT code for “set radiation therapy field.”
http://a257.g.akamaitech.net/7/257/2422/01jan20061800/edocket.access.gpo.gov/2006/pdf/06-5665.pdf
http://www.accc-cancer.org/PUBPOL/pdf/pubpol_PFScomments.pdf
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