Demand For Prostate Cancer Brachytherapy Program in Ambulatory Surgery Centers Enhanced by New CMS Reimbursement Policy
12 February 2008 - 11:00PM
Marketwired
PITTSBURGH, PA , a Pittsburgh-based cancer treatment solutions
group announced today that it has seen a substantial increase in
inquiries and demand for new prostate cancer brachytherapy programs
by the ambulatory surgery center market since the first of this
year. The increase is based on January 1, 2008 changes and
additions from the Center for Medicare and Medicaid Services (CMS)
to approved reimbursement codes for ambulatory surgery centers
(ASC).
Beginning January 1, 2008, CMS approved ASCs to bill for all
technical services for the day of the implant of radioactive seeds
for the treatment of prostate cancer. This was in addition to
several hundred other new procedures also approved to be reimbursed
in ambulatory surgery centers. The CMS reimbursement approval
included the disposable radioactive seeds which will be reimbursed
on a 'per seed' basis. Additionally, the ASCs will continue to be
allowed to bill its facility fee, CPT code 55875, which has a
reimbursement of $1,377, adjusted to the local wage index for the
ASC. This facility 'pricer code' is the highest facility
reimbursement code for an ambulatory surgery center operating room
case.
In addition to the approval of these new codes, an exemption has
been given for physician-owned ASCs in that they will not be in
violation of Federal Stark regulations if they perform and bill for
these codes. Up to December 2007, the radioactive seeds were
mandated by CMS to be billed by the radiation oncologist due to the
procedure being deemed a 'designated healthcare service' (DHS) and
fell under Federal self-referral laws if physicians referred
patients to the ASC in which they had ownership and that ASC billed
for the technical services and for the radioactive seed
sources.
Oncology Med, Inc. provides a full turnkey program for ASCs and
was the first agency to license an ASC to perform such services
when CMS first approved the procedure to be reimbursed in an ASC in
2003. Since that time, Oncology Med has been instrumental in
licensing and bringing up new prostate cancer brachytherapy
programs at ASCs in over 12 states and is considered the leading
authority on ASC licensing and implementation of prostate cancer
brachytherapy programs.
"We are pleased to see the significant increase in demand for
our programs in the ASC arena," stated William Walker, Ph.D., CEO
of Oncology Med (OMI). "This is good for the ASCs, the physicians,
and the patients. The increase in reimbursement to the ASCs who
generally can provide this service at a lower cost to Medicare and
other private commercial insurance payers is a win for everyone as
well as the economy and subsequently will reflect a lower co-pay
for each patient than traditional hospital services."
According to Jack Sloan, Senior Vice President of Business
Development for OMI, "While prostate cancer brachytherapy has been
on the rise in the ASCs since 2003, the major hurdle for a more
rapid acceptance up to this point was the requirement of the
radiation oncologist to bear the financial burden of the disposable
radioactive seeds which could range from $1,500 to $4,000 per case
depending on what source, Palladium or Iodine, and the quantity of
seeds required for the treatment of the patient's cancer. At the
rate of 3-5 cases per month for an average radiation oncologists,
this could be quite a burden on a radiation oncology practice's
cash flow which will now be borne by the ASC that is more
positioned and experienced to manage this cost."
In answering the question of how fast can an ambulatory surgery
center get up and running for the treatment of prostate cancer in
its center, Dr. Walker said, "If they already have a radiation
license we can have them ready to perform cases within 30 days
pending no obstacles. If they do not currently have a radiation
license, it may take up to 90 days to get the application submitted
and the license back in hand, but by the time we do get the
license, we will have everything else ready and in place to begin
accepting patients and performing brachytherapy implants."
According to the American Cancer Society, this year
approximately 180,000-200,000 new prostate cancer patients will be
diagnosed and receive some type of treatment for the disease. In
most cases, the treatment of choice is radiation which has been
shown to have equivocal cure rates in studies as compared to
conventional prostate surgery, but with lower percentages of post
treatment complications of impotence and incontinence.
Oncology Med continues to expand and provide extensive
consultation services for new and expanded cancer center
construction, certification and credentialing processes for Joint
Commission, as well as, physics staffing and support, and complete
turnkey solutions for continuation or implementation of radiation
treatment programs for ambulatory surgery centers, radiation
oncologists, urologists, and hospitals.
About Oncology Med, Inc.
Oncology Med is a public company engaged in the fulfillment of
services related to the treatment of various cancers. It currently
provides analysis and design of radiation treatment plans in order
for radiation oncologists to administer radiation treatments to
cancer patients. Current services facilitate radiation treatment
programs ranging from external beam radiation to more advanced
radiation treatment technologies.
More information about Oncology Med, Inc. can be found at
www.oncologymed.com.
NOTE: This press release may contain "forward-looking
statements." In some cases, you can identify forward-looking
statements by terminology such as "may," "will," "should," "could,"
"expects," "plans," "intends," "anticipates," "believes,"
"estimates," "predicts," "potential," "continue" or the negative of
such terms and other comparable terminology. These forward-looking
statements include, without limitation, statements about our market
opportunity, our strategies, competition, expected activities and
expenditures as we pursue our business plan, and the adequacy of
our available cash resources. Although we believe that the
expectations reflected in any forward-looking statements are
reasonable, we cannot guarantee future results, levels of activity,
performance or achievements. Actual results may differ materially
from the predictions discussed in these forward-looking statements.
Changes in the circumstances upon which we base our predictions
and/or forward-looking statements could materially affect our
actual results.
For information, please contact: William J. Walker, PhD Email
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