| According to the American Cancer Society, cancer is | | | | competitive advantage over radiation oncology |
| second to heart disease as the leading cause of | | | | centers that offer a full range of treatment for |
| death in the United States. Radiation therapy is given | | | | cancers. Patients are unaware of the financial |
| to over 65% of all cancer diagnoses. As seen in the | | | | incentives and the impact on care. ASTRO has called |
| data presented at many of our meetings, we have | | | | upon Congress to strengthen the "Stark" law by |
| made great strides over the last decade with | | | | removing radiation oncology from the "in-office |
| increased survival rates. Major advances in technology | | | | ancillary" exception list. |
| have also allowed us to minimize the side effects | | | | Medicare Physician Fee Schedule |
| seen with treatment. These changes have brought | | | | Major overhauls are needed in the formula that is |
| radiation oncology to the forefront of cancer care, | | | | used to calculate physician payments. Every year, |
| yet it is still misunderstood by many lay people what | | | | congressional action is taken to "patch" the system |
| we do. Very often there is confusion that leads to | | | | to avoid significant reductions in reimbursement. In |
| the notion that we are "part" of radiology. As we are | | | | 2010, we face a 21.5% cut in reimbursement while |
| aware, this is simply not the case. | | | | the cost of providing the care is increasing due to |
| Attendees were briefed by the ASTRO government | | | | technological advances, salaries and general inflation. |
| relation's staff on the issues facing our profession. | | | | The problem lies within the sustainable growth |
| There were many guest speakers from legislative | | | | formula (SGR). This concept was to reduce |
| leaders to health care consultants. The three primary | | | | payments as the number of services that are |
| issues we face today are self-referral, proposed cuts | | | | provided grows. The flaw in this formula is that it |
| to the Medicare physician's fee schedule and | | | | includes prescription drugs. ASTRO has called upon |
| increases in funding for cancer research. | | | | Congress to prevent the 21.5% cut scheduled for |
| Self-referral | | | | 2010 and replace it with a positive payment update |
| The physician self-referral or "Stark" law was enacted | | | | and work towards a long-term solution to stabilize |
| to prohibit physicians from referring Medicare patients | | | | payments. |
| for healthcare services when the physician has a | | | | Cancer Research Funding |
| financial interest with the service provider. The intent | | | | Funding of research at the NCI is a priority in the war |
| was to assure that clinical decisions related to patient | | | | against cancer and saving lives. During the 1990's, |
| treatment were made without financial | | | | funding to the NCI was increasing annually. However, |
| considerations, assuring patient access to high-quality | | | | in the last eight years, funding has remained flat. |
| services and discouraging overutilization. | | | | During this time the cost of research has increased, |
| Unfortunately, a loophole was added to the law. The | | | | thereby limiting what research is being done. While |
| "in-office ancillary services" exception (IOAE) was | | | | we are grateful for the $10 billion that was included |
| intended to apply to services such as x-rays and lab | | | | for the NIH in the President's stimulus package, the |
| tests that required a quick turnaround to facilitate | | | | lack of continued investment in cancer research |
| medical care. | | | | leaves us further behind in conducting research and |
| Radiation oncology was added to that list. Our | | | | saving lives. ASTRO has called upon Congress to |
| service is not ancillary to any other. As a result, | | | | double funding for cancer research, thus ending the |
| arrangements have been made, most notably in New | | | | declining funding trends for the NCI. |
| York, whereby urologists have formed a group that | | | | This year's ASTRO Advocacy Day's success can only |
| has invested in linear accelerators and now are able | | | | be determined by the actual changes that take place |
| to diagnose and treat prostate cancer patients while | | | | in the coming months. Meetings with the House and |
| capturing all the technical charges associated with the | | | | Senate members was positive, and they now have a |
| treatment. These business arrangements have the | | | | better understanding of the issues we face and the |
| financial incentive to "cherry-pick" cancer patients for | | | | impact of the decisions over the coming months will |
| the most profitable treatments, giving them a | | | | have on our practices and those we treat. |