Hematology and Oncology practices across our state and across the country are dealing with continuing problems associated with reimbursements for the critically important care we provide.  As oncology practices have been very successful in making cancer a “chronic illness”, rather than an immediate “death sentence”, the costs associated with the initial and maintenance treatments of neoplastic and blood disease have risen exponentially.  With these high costs come efforts by the federal programs and private payers to find methods of reimbursement containment, while not destroying quality of care.
 

Our most critical issues to date include, but are not limited to:

1. The Medicare Physician Fee Schedule – the newly updated sustainable growth rate formula has not changed, so we will experience a negative 9.9% decrease in physicians reimbursements in 2008. Congress needs to act, once again, to save us from another cut in physician payments.

2. RVU’s continue to require budget neutrality if increases or decreases exceed $20 million

3. New bills being presented to change the formula for payment of drugs and biologics, excluding prompt pay discounts from manufacturers to wholesale distributors.

4. CAP program with modifications to requirements.

5. ASP calculations with bundled price concessions.

6. The new reporting requirements for use of ESA’s given in conjunction with anti-cancer treatments.