[Congressional Record (Bound Edition), Volume 145 (1999), Part 3]
[Extensions of Remarks]
[Page 4371]
[From the U.S. Government Publishing Office, www.gpo.gov]




    INTRODUCTION OF THE MEDICARE FULL ACCESS TO CANCER TREATMENT ACT

                                 ______
                                 

                            HON. GENE GREEN

                                of texas

                    in the house of representatives

                        Thursday, March 11, 1999

  Mr. GREEN of Texas. Mr. Speaker, today I am introducing the Medicare 
Full Access to Cancer Treatment Act. This bill is critical to protect 
the Medicare beneficiary's access to the newest and best treatments for 
cancer.
  The BBA of 1997 directed HCFA to implement a prospective payment 
system (PPS) for hospital outpatient services provided through the 
Medicare program. When Congress passed this requirement, we recognized 
that some services would be difficult or impossible to include in a PPS 
and therefore authorized HCFA to use its discretion to exclude certain 
services from the payment system. Unfortunately, under their proposed 
rule, HCFA would bundle the costs of all cancer drugs into a small 
number of Ambulatory Payment Categories (APCs) and pay hospitals only 
for the average cost of these services.
  The main problem with this proposal is that it fails to recognize the 
complexities of cancer treatments and the wide range and individual 
needs of each patient with cancer. As a result, the new payment system 
could threaten the quality and availability of cancer treatment for 
Medicare beneficiaries. In fact, under HCFA's plan, the lowest 
reimbursement rate for some cancer treatments would be only $52.70 
(which is expected to include supportive care such as anti-nausea 
drugs)! Moreover, under the proposal, new drugs, which are defined as 
anything after 1996, would be reimbursed at this lowest rate. Such a 
policy would have a crippling effect on research and development for 
new drug therapies.
  This policy will create an overall reduction in the quality of 
patient care since hospitals will be pressured to provide the least 
expensive, rather than the most effective treatment. Moreover, research 
and development for new drug therapies may be diminished or delayed, 
ultimately denying the patients of today and those of future 
generations access to more effective treatments.
  To correct this problem, the Medicare Full Access to Cancer Treatment 
Act would carve-out cancer treatment from the outpatient PPS. This 
simple yet sensible action would fully protect Medicare beneficiaries' 
continued access to the best and most effective cancer care.
  I am pleased to introduce this legislation with over twenty 
bipartisan original cosponsors as well as the support of several 
patient and provider organizations, including Center for Patient 
Advocacy, National Alliance of Breast Cancer Organizations, Cancer 
Care, Inc., Cancer Research Foundation of America, Oncology Nursing 
Society, Association of Community Cancer Centers, Lymphoma Research 
Foundation of America, Alliance for Lung Cancer Advocacy, Support and 
Education, Lupus Foundation of America, US-TOO International and the 
Multiple Myeloma Research Foundation.

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