November 02, 2011

Schumer, Gillibrand, Higgins Successfully Change Medicare Rule To Provide $3.2 Million Per Year To Roswell Park Cancer Institute

Schumer, Gillibrand & Higgins Worked To Secure CMS Rule Change That Will Boost Medicare Funding to Roswell Park Cancer Institute by $3.2 Million

Today, U.S. Senators Charles E. Schumer, Kirsten Gillibrand, and Congressman Brian Higgins (NY-27) announced that they have successfully secured a Medicare payment improvement resulting in Roswell Park Cancer Institute receiving $3.2 million more each year from the federal government to provide state-of-the-art cancer care to New Yorkers. Roswell Park, Upstate New York's only NCI-designated Comprehensive Cancer Center, is a leader nationwide in alleviating suffering due to cancer. Due to technological and scientific advancements, which many Roswell clinicians and researchers have played an important role, more and more cancer patients are receiving care in an outpatient setting instead of inpatient hospital stays. But payment from the federal government for this type of care has been woefully inadequate, creating a potential roadblock for hospitals like Roswell Park in continuing to provide quality care to patients.

The Final Rule that Schumer, Gillibrand and Higgins have announced will change this inequitable predicament by increasing and adjusting the amount Roswell Park and U.S. cancer hospitals like it will be paid for the high quality outpatient care that they provide.

“Roswell Park Cancer Institute is at the cutting edge of cancer treatment, using an outpatient model that allows patients to spend more time with their family – unfortunately, federal rules were penalizing their pioneering work, but now we have rectified that” said Schumer. “The government should help hospitals that provide cutting-edge cancer care, not hold them back. I’m pleased CMS has made this payment change that will put more power behind Roswell’s fight against this devastating illness that has taken the lives of far too many already.”

“New Yorkers suffering from cancer and the families that stand by them deserve the best possible care, and nothing should stand in the way,” Senator Gillibrand said. “This rule change is a critical step to arm Roswell with more of the resources and freedom it needs to build on the first-rate cancer care they provide, and save more lives.”

“This is a significant victory for cancer care in Western New York and the nation as we strive for a health care system that keeps pace with today’s medical advances and breakthrough treatments,” said Congressman Higgins, a member of the Congressional Cancer Caucus.  “This reimbursement change frees up critical resources for Roswell Park, as they continue their life changing work and  innovative research leading to tomorrow’s cures.” 
Founded in 1898, Roswell Park Cancer Institute is considered to be the first comprehensive cancer center in the country. RPCI continues to be at the vanguard of new generations of treatments. In this new era, cancer patients are more likely than ever to be treated in an outpatient setting as technology has allowed for more effective and precise radiation and chemotherapy treatments administered in ways that are less invasive for patients, allowing for increased and improved quality of life. The federal government, through Medicare, has unfortunately been slow to recognize the value of these changes. Roswell Park, as well as 9 other leading cancer centers across the country, were being vastly underpaid by the federal government yet are rightfully expected to provide the highest quality care.

For outpatient services, the cancer centers are currently reimbursed by Medicare approximately $0.83 on the dollar. As a result, the U.S. cancer centers’ Medicare outpatient losses have become unsustainable – $134 million per year nationwide, and growing. But the new CMS Final Rule that Schumer, Gillibrand, and Higgins pushed for will help Roswell Park continue to be able to provide high quality cancer care in outpatient settings, so that patients can be at home with loved ones and not stuck in the hospital. 

In the 2012 Outpatient Prospective Payment System (OPPS) Final Rule announced yesterday, the Centers for Medicare and Medicaid Services (CMS) resolved a payment reimbursement issue critical to Roswell Park in Buffalo, as well as Memorial Sloan Kettering in Manhattan. Inpatient and outpatient treatment will be reimbursed in a manner such that the two types of treatment facilities will receive equal Medicare payments, thus ending the disadvantage for outpatient care providers.

In addition to its significant public health role for the community, Roswell Park is a prominent employer, employing over 2,000 high skilled jobs for Western New Yorkers.