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Medicare Modernization Act not associated with major changes in access to chemotherapy
Date:7/8/2008

Despite concerns that reductions in physician reimbursements for outpatient chemotherapy related drugs as a result of the Medicare Modernization Act of 2003 would have a detrimental effect on patients requiring chemotherapy, new research indicates that there have not been major changes in travel distance and patient wait times for chemotherapy in the Medicare population since 2003, according to a study in the July 9 issue of JAMA.

In addition to establishing an outpatient prescription drug benefit for Medicare beneficiaries, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) changed physician reimbursement for chemotherapy-related drugs and administration services. Before the enactment of the MMA, Medicare reimbursement to physicians for chemotherapy drugs often exceeded acquisition costs because many physicians obtained the drugs at substantially discounted prices. In an effort to curtail this overpayment and align reimbursement more closely with market prices, the MMA reduced payments for chemotherapy drugs, according to background information in the article.

" there was concern that the reduction in physician reimbursement would lead to closures of some private oncology practices, requiring the 80 percent of cancer patients who receive treatment in community settings to travel farther from their homes to local hospitals for treatment. Moreover, without sufficient opportunity to plan and expand their services and without financial incentive to do so, hospital-based clinics might not have adequate resources to support the anticipated rapid influx of patients seeking chemotherapy, thereby further delaying provision of care," the authors write.

Alisa M. Shea, M.P.H., of Duke University School of Medicine, Durham, N.C., and colleagues examined patient wait times and travel distance for chemotherapy before and after the enactment of the MMA by conducting an analysis of a nationally representative 5
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Contact: Michelle Gailiun
919-660-1306
JAMA and Archives Journals
Source:Eurekalert

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