The letter, issued by Dr. Barry Straube, the chief medical officer of CMS, was addressed to the American Society of Hematology, US Oncology and the American Society of Clinical Oncology, and outlined limitations on coverage of erythropoietin stimulating agents (ESAs) for cancer patients. CMS stated that they would only reconsider amending the cancer National Coverage Determination (NCD) for ESAs if evidence is submitted within 30 days to challenge the ruling.
Physicians representing US Oncology expressed "serious concern" over this ruling, following an extensive presentation of clinical evidence initially challenging the CMS decision in July, and providing detailed evidence seeking a reconsideration of the policy. US Oncology, due to its size and reporting protocols is regarded as having some of the most accurate clinical data, provided their findings in several meetings and letters to officials within CMS.
US Oncology maintains that "CMS' decision is based on misinterpretation of current scientific data, and should be immediately revised. We have provided comprehensive, science-based answers to the questions posed by CMS," said Cohen. "The new policy overlooks that evidence, and will interfere with doctors' patient protocols and clinical judgment, thereby jeopardizing patient care."
US Oncology also believes that the new policy will create "two-tiers" of cancer treatment in America. Patients with private insurance will continue to receive appropriate ESA treatment based on universal clinical protocols developed and refined over more than two decades based on a trove of clinical outcomes data.
Under the new policy, Medicare beneficiaries risk dropping to hemoglobin levels oncologists regard as inappropriately low levels, and as a result, will risk being forced to undergo blood transfusions.
"Medicare beneficiaries who are battling cancer are alread
|SOURCE US Oncology|
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