CMS letter: please take 5 minutes to submit!

[thesauce]

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As promised, I've attached several versions of a letter to submit to CMS to address the upcoming proposed rule changes.

I know that radoncs have typically been horrendous at advocating for themselves, but for those that can spare a few minutes to save our field, it would be appreciated.

 

[Gfunk6]

Writing a letter to Dr. Oz and begging him not to cut my Medicare reimbursement was not on my 2025 bingo card.

 

[thesauce]

Writing a letter to Dr. Oz and begging him not to cut my Medicare reimbursement was not on my 2025 bingo card.

Better we don't do anything?

 

[TheWallnerus]

As promised, I've attached several versions of a letter to submit to CMS to address the upcoming proposed rule changes.

I know that radoncs have typically been horrendous at advocating for themselves, but for those that can spare a few minutes to save our field, it would be appreciated

46% reduction in each IG-IMRT fraction

Hoo boy

Remember that one woman at a Hillary Clinton town hall who said “I would love to vote Democrat but it will cost me a lot of money.”

med student: I would love to go in to rad onc but I don’t wanna be poor!

 

[DrProtonX]

I know this might sound very harsh but why aren’t we stop taking medicare? Many other specialties have done it. People always come up with money to get cosmetic procedure, I’m sure they’ll come up with money when their life is on the line. Again, this isn’t right but when medicare keep cutting reimbursements, what other choice do we have? It’s time for people to feel the consequences of the choice they make when they vote. We are sacrificing way too much to be the ones to get the end of the stick

 

[medgator]

I know this might sound very harsh but why aren’t we stop taking medicare? Many other specialties have done it. People always come up with money to get cosmetic procedure, I’m sure they’ll come up with money when their life is on the line. Again, this isn’t right but when medicare keep cutting reimbursements, what other choice do we have? It’s time for people to feel the consequences of the choice they make when they vote. We are sacrificing way too much to be the ones to get the end of the stick

Good one

Have you seen the demographics of many of our patients?

Can get away with it if you've got the name firepower of a Mayo etc

Mayo Clinic in Arizona to stop treating some Medicare patients

The Mayo Clinic stopped accepting Medicare patients on Jan 1 at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic...

www.healthleadersmedia.com

 

[TheWallnerus]

I know this might sound very harsh but why aren’t we stop taking medicare? Many other specialties have done it. People always come up with money to get cosmetic procedure, I’m sure they’ll come up with money when their life is on the line. Again, this isn’t right but when medicare keep cutting reimbursements, what other choice do we have? It’s time for people to feel the consequences of the choice they make when they vote. We are sacrificing way too much to be the ones to get the end of the stick

The commercials peg their reimbursement to Medicare reimbursement. And when Medicare deletes a code, or adds a code, or changes a code definition, the commercials immediately follow suit. And Medicare Advantage plans must legally behave just like Medicare would. You can stop “taking Medicare” like the world economy can stop using the American dollar. Self pay for cancer RT sounds nice, but the self payers will often times be seen for RT after surgery and/or chemo has severely strained that self pay budget.

 

[thesauce]

It’s disappointing when, instead of getting a lot of support for writing a letter to combat these cuts, we instead launch into another discussion and the only remotely relevant comment is a joke about the letter itself.

I’ll do what I can personally, but our field is f—- and in the end we only have ourselves to blame

 

[Gfunk6]

It’s disappointing when, instead of getting a lot of support for writing a letter to combat these cuts, we instead launch into another discussion and the only remotely relevant comment is a joke about the letter itself.

I’ll do what I can personally, but our field is f—- and in the end we only have ourselves to blame

Don't take it too hard. Your final comment is something I agree with wholeheartedly. You have to understand that we all come from diverse practice settings (academic mothership, academic satellites, hospital employed, pro only contracts, oncology mega groups like USON, etc.). We are not all rural Rad Oncs who have the same needs expressed in this letter. Many of us rely on our parent organizations, USON in my case, to advocate aggressively on our behalf.

In the end, the CMS cuts will hit but with a lesser amount than originally proposed. As I posted on another thread, CMS prefers uniform voices from professional socieites. We have that for the most part (agree or disagree). Sending individual letters that undermine that will be irrlevant at best and counter-productive at worst.

 

[medgator]

CMS prefers uniform voices from professional socieites.

ASTRO long ago decided where its bread was buttered.

 

[A_DeMichele]

why and how exactly is there a 46% cut in IMRT?

 

[thesauce]

As I posted on another thread, CMS prefers uniform voices from professional socieites. We have that for the most part (agree or disagree). Sending individual letters that undermine that will be irrlevant at best and counter-productive at worst.

CMS says that because they are lazy. They want to read two letters and not a thousand. But it’s reality, human nature and common sense that a thousand letters saying these cuts are devastating will be more impactful than two.

The societies are focused on hospital-based and academic centers which really aren’t getting hurt too much with these cuts. Some are getting a windfall. ASTRO especially could care less about the free-standing centers that are getting crushed as we are a smaller % of their members.

 

[thesauce]

why and how exactly is there a 46% cut in IMRT?

14 to 7.48 RVUs. It’s explained in the first few letters.

 

[deleted1217978]

why and how exactly is there a 46% cut in IMRT?

They got rid of the IMRT delivery codes and are now grouping it with 3D in a much lower reimbursing code. The modality of IMRT no longer gets you a higher payment. You have to have multiple isocenters or other complexities.

I know this might sound very harsh but why aren’t we stop taking medicare?

Because <1% of the population can afford to pay for cancer treatment out of pocket and insurance companies follow medicare. Also, cancer is a disease of the elderly, and by refusing straight medicare and medicare advantage you would be losing well over half of your patients. There are very few if any avenues for niche cash-based radiation oncology.

How many people can afford to self-insure their house? Or even their car? Hell, people literally insure iphones, and I would bet the majority do this. Insurance (other than liability) is financially stupid once you have enough money (technically gambling where you do not have the edge).

 

[evilbooyaa]

Hard for me to take the goals of this sort of document seriously when the linked word document doesn't even lead you to the correct place on regulations.gov.