Proposed budget would cut PCa programs

Bob GattyWashington-Congress doesn’t appear to like very much President Obama’s FY 2016 budget proposal to eliminate funding for Centers for Disease Control and Prevention (CDC) activities that are focused on education about prostate cancer screening and treatment, as well as tracking disease incidence and mortality data. 

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Both the House and Senate appropriations committees in late June restored $13.2 million that the administration’s budget plan sought to eliminate, and the prospects for that funding to remain in the ultimate budget appear to be bright. 

In other developments, the Centers for Medicare & Medicaid Services released a plan to cut hospital and ambulatory surgical center (ASC) outpatient payment rates, and a bill was introduced that would allow doctors to use electronic health records at ASCs without losing incentive payments.

The summary of the President’s budget plan explained the proposed elimination of prostate cancer funding as follows:

“The FY 2016 budget request eliminates funding for prostate cancer activities. While the evidence on prostate cancer screening remains unclear, CDC has conducted extensive research on and developed materials to help doctors and other health providers better communicate with their patients about informed decision making related to prostate cancer screening and treatment. The proposed elimination will not impact CDC’s ability to collect data on national prostate cancer incidence through the National Program of Cancer Registries, nor hinder the ability to share resources and lessons learned.”

That action by the administration resulted in prostate cancer interest groups organizing a concerted campaign on Capitol Hill to convince lawmakers to restore those funds. They aligned themselves with organizations advocating for funding for the national breast and cervical cancer early detection program and the colorectal cancer control program, which Obama’s budget proposal also sought to slash.

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In a letter to leaders of both the House and Senate appropriations committees in March, a coalition of 41 organizations, under the name One Voice Against Cancer, said the targeted programs “play an indispensable role in the prevention, detection, and treatment of cancer.”

That letter pointed out that prostate cancer strikes one in six men and accounts for 33% of all cancer cases, with 220,000 men newly diagnosed annually and causing 275,000 deaths.

“CDC-supported cancer programs improve the health of all Americans by leveraging strong partnerships with state and local agencies, many of which will be forced to terminate their prostate cancer control programs if federal funding is lost,” the letter said. “Continued funding for this program will enhance prostate cancer data in cancer registries, especially information about the stage of the disease at the time of diagnosis, quality of care, and the race and ethnicity of men with prostate cancer.”

One Voice also pointed out that CDC funding for prostate cancer has supported “critical research on the patient-provider dialogue, as well as the dissemination of materials to ensure men and their healthcare providers make the most informed decisions possible in their specific circumstances. The need for these resources is stronger than ever as men weigh screening decisions and an increasing number of treatment options.”

Included in the One Voice coalition are the National Alliance of State Prostate Cancer Coalitions, the Prostate Conditions Education Council, and Us TOO International Prostate Cancer Education and Support Network. Other groups joining the fight against the cuts included ZERO–The End of Prostate Cancer and Malecare.

NEXT: Proposed rule would cut outpatient pay

Proposed rule would cut outpatient pay

Meanwhile, at CMS, a plan was released July 2 to reduce hospital and ASC outpatient payment rates and to provide a 2% update in the conversion factor for the Medicare physician payment schedule. The proposed rule also includes changes to the Two Midnight Rule for calendar year 2016.

Under CMS’s plan, outpatient payment rates would be decreased by .01%, but would include a 2% increase to account for inflation in Outpatient Prospective Payment System payments for laboratory tests.

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In addition, CMS plans a 2% payment reduction to outpatient hospital departments and ASCs that failed to meet the agency’s quality reporting program requirements.

The Two Midnight Rule, which states that most inpatient hospital stays will be paid for if they are expected to cover more than two midnights, will now include some exceptions to be determined by the physician responsible for caring for the patient, subject to medical review. However, CMS said that stays less than 24 hours are not likely to qualify for an exception.

Meaningful use update

Legislation was approved in late June by the Senate Finance Committee that would allow physicians to use electronic health records at ASCs without loss of financial incentive payments under the federal meaningful use program that was established in 2009.

The Electronic Health Fairness Act of 2015, sponsored by Sen. John Isakson (R-GA), would prohibit any patient encounter of an eligible professional occurring at an ASC from being counted toward the threshold physicians must meet to qualify for meaningful use incentives. The exclusion would end 3 years after EHR technology for ASCs is certified by the Department of Health and Human Services.

Currently, physicians must use a certified technology to conduct at least 50% of their patient encounters, which can have the practical effect of forcing providers to shift patients away from ASCs and into hospitals.

An identical bill, sponsored by Rep. Diane Black (R-TN), was passed by the House Ways and Means Committee earlier this year.

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