Raises Concerns over “Value-based Modifier,” Other Provisions

In comments to the Centers for Medicare and Medicaid Services on the 2013 proposed physician fee schedule, ASCO commends the agency for adding new oncology measures to its Physician Quality Reporting System (PQRS). 

ASCO and the American Society of Radiation Oncology (ASTRO) have been encouraging CMS to adopt such measures, and hopes CMS will include this provision in the final fee schedule. ASCO strongly believes that the addition of these measures will help increase the feasibility of the PQRS participation for oncologists—although raises concerns about the federal government’s capacity to conduct “meaningful quality assessment across the field of medicine.” ASCO believes that specialty society registries, such as that provided by ASCO’s Quality Oncology Practice Initiative, should be used to meet PQRS participation requirements.

Further, ASCO questions CMS about its proposed “value based modifier” program and the lack of measures to guard against under-utilization of and disparities in cancer care.  ASCO’s comments also address e-prescribing incentive programs, the proposed post-discharge care coordination G-code, and the lack of a permanent fix to the Sustainable Growth Rate formula.

In additional comments to CMS on the proposed changes to the Hospital Outpatient Prospective Payment System, ASCO supports CMS’s proposal to set reimbursement for separately paid drugs and biologics at average sales price + 6 percent—although strongly disagrees with the CMS decision to package all contrast agents and diagnostic radiopharmaceuticals, a stance ASCO has held for several years.