COA States "CMS Release Of Medicare Claims Data Misleading, Confusing, And Potentially Harmful To Cancer Patients"

WASHINGTON, April 11, 2014 /PRNewswire/ -- The Community Oncology Alliance (COA) has issued a statement on the release of physician-specific Medicare reimbursement claims data by the Centers for Medicare & Medicaid Services (CMS) in which COA outlines serious concerns with the data. COA finds the data to be incomplete, biased, without context, and an unrepresentative sample of Medicare reimbursement claims data submitted by oncologists. Most alarming are the invalid assessments of oncologist productivity that can compound the challenges and decisions facing seniors and other cancer patients.

"I have been an oncologist for 29 years, have treated over 18,000 patients, and I have never seen anything from our government so irresponsible and with such potential to endanger the treatment of cancer patients nationwide," said Mark Thompson, MD, COA president and an oncologist at The Zangmeister Center in Columbus, Ohio. "News stories based on erroneous analyses of Medicare claims data will only serve to add angst and confusion to the already stressful challenges of Americans dealing with cancer."      

According to COA's analysis of the Medicare data files, the incomplete nature of the data released, in conjunction with Medicare billing regulations, invalidates CMS' stated purpose that the data "will help beneficiaries and consumers better understand how care is delivered through the Medicare program."  COA's statement details specific reasons why comparisons between community oncologists and hospital oncologists are apples to oranges and why comparisons among community oncologists are meaningless. 

COA strongly supports identifying physicians abusing the Medicare system by fraudulently billing, as well as increasing the transparency and accountability in medical care, as evidenced by COA's Oncology Medical Home and payment reform initiatives.  However, Medicare reimbursement claims data, devoid of any quality and value metrics, and distorted by Medicare billing regulations, will not increase transparency. It will only confuse and cloud cancer patients' decision making.

"I am appalled that CMS would not allow physicians to check the accuracy of their data and to anticipate patients' questions before release to the public," stated Ted Okon, executive director of COA. "CMS obviously released the data files in advance to select news outlets to develop data search and reporting tools that are facilitating distortion of this incomplete data. This calls into question whether this is about enhancing the quality and value of medical care or simply driving down costs by creating mistrust between patients and their physicians." 

The full statement can be found here.

About Community Oncology Alliance (COA)

The Community Oncology Alliance (COA) is a non-profit organization dedicated solely to community cancer care, where almost 65% Americans with cancer are treated. Since its formation more than 10 years ago, COA has led community cancer clinics in navigating the increasingly challenging environment to provide efficiencies, patient advocacy and proactive solutions to the Congress and policy makers. COA members have testified before both chambers of Congress, authored cancer care demonstration projects, and been instrumental in the passage of oral cancer drug parity legislation, among many other initiatives. More information can be found at the COA website. 

COA is leading a multi-stakeholder group that is developing and implementing an Oncology Medical Home cancer care model and is advancing payment reform for cancer care. More information can be found at the Oncology Medical Home website.  

About COA Patient Advocacy Network (CPAN)

The COA Patient Advocacy Network (CPAN) was created in 2010 to advocate for access to local affordable care for all cancer patients. More information can be found at the CPAN website.

SOURCE Community Oncology Alliance