Two months ago, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would create new payment models meant to reimburse providers for assigning prescription drugs. This would change the payment structure of Medicare Part B. The proposed regulations are meant to help providers find the right medication for their patients under a renovated Medicare Part B payment system. However, not all stakeholders are onboard with this change.

The Community Oncology Alliance (COA) submitted comments to CMS two days ago stating that this proposed rule should be completely blocked, according to a COA press release.

The organization directs CMS to data that shows this new proposed rule for Medicare Part B payment policy is “bad medicine, flawed economics, and destructive.” In fact, COA is concerned enough about this particular change that it is willing to pursue legal action to put an end to the proposed rule, the press release mentions.

The problem at hand is that this new proposed rule for Medicare Part B reimbursement could potentially endanger patients by changing the way oncologists assign medication. In particular, the proposed rule seeks to reform clinical decision-making without having a clear understanding of the way drugs are prescribed in the oncological setting.

Additionally, the release states that CMS does not have a system for allowing patients to “opt-out” of this new drug prescribing structure nor does the proposed rule allow for “informed consent.” The comments from COA argue that in order to have positive patient health outcomes, oncologists should not be pushed to utilizing lower-priced drugs.

The organization further contends that CMS attempts at cutting costs on cancer care and prescription medication only further led patients into being admitted to hospitals, which ultimately leads to more expensive medical care.

“It’s alarming to think that some government bureaucrats, who have never practiced medicine, are telling me, a Board-certified oncologist with 18-years of experience, that I’m not treating my patients appropriately,” Jeffrey Vacirca, MD, Vice President of COA and CEO of NSHOA Cancer Center in East Setauket, N.Y., said in a public statement. “My patients come first – always come first – and I spend a lot of time personalizing their care and treatment. What the government wants to do is come between me and my patients, forcing cookie-cutter medicine that they think is right.”

The letter from COA sent to Andy Slavitt, Acting Administrator at CMS, regarding the Medicare Part B proposed rule outlines that there may be legal issues tied to revamping drug prescribing practices for cancer care among seniors.

Bruce Gould, MD, President of the Community Oncology Alliance, writes in the letter that CMS is suggesting oncologists around the country are not using the best standards of care when it comes to treating their patients. This type of questioning, according to Gould, is not productive at improving payment models within the oncology field.

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