Protect Patient Access to Office-Based Radiation Oncology

ACRO applauds the filing of H.R. 3674, the “Providing Relief and Stability for Medicare Patients Act of 2023.” H.R. 3674 is bipartisan legislation that mitigates cuts to office-based radiation oncologists and other specialists and avoids significant disruptions in patient access to care.

Office-based specialty care is a critical component of our Nation’s healthcare system. These specialists provide a wide range of services to patients with cancer, end-stage renal disease, eye disease, fibroids, limb salvage and venous ulcer needs, and other conditions. The office setting is also critical for patient access (especially in rural and underserved areas) and lower patient copays. Unfortunately, the prolonged instability within the Medicare Physician Fee Schedule (PFS)—driven by statutory payment cuts, perennial lack of inflationary updates, significant administrative barriers, and the cumulative impact of the pandemic—is jeopardizing the financial viability of many community, office-based, physician practices.

H.R. 3674 would provide targeted relief for office-based radiation oncologists and other specialists that utilize high-tech medical devices and/or equipment and thus were most negatively impacted in the 2022 PFS with the updating of the clinical labor costs in the budget neutral practice expense methodology.

Failure to pass H.R. 3674 will result in more providers leaving the field (either through retirement or career adjustment), more radiation oncology centers being closed or sold, and a significant number of patients losing access to a variety of healthcare services in their communities.

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The Problem

The 2022 Medicare Physician Fee Schedule (PFS) final rule issued on November 2, 2021, cuts a broad array of office-based specialists as a result of so-called “budget-neutral” effects of the CMS policy to update clinical labor data in the PFS. These cuts will continue to accelerate the health system consolidation trend and exacerbate health inequities in a variety of diseases. “Budget-neutrality” also was the driver of massive cuts in the 2021 PFS Final Rule. These year-over-year “budget-neutral” cuts, being implemented during a pandemic, are causing significant disruption to the healthcare system and are being implemented without regarding to patient outcomes, actual PFS provider resource needs, or any other rationale policy.

In the near-term, we implore Congress not finalize these cuts to office-based specialists. Over the long-run, we urge CMS and Congress to work on fundamental reform to the PFS to provide reimbursement stability to office-based specialists, stop the troubling health system consolidation trend, and close health equity gaps.

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