Medicare Changes May Impact Prostate Cancer Treatment

A loophole in the new Medicare Prescription Drug and Modernization Act may negatively impact your prostate cancer treatment – or the treatment of someone you love.

Prostate cancer patients currently have a range of hormone therapy choices that allow treatment over various time periods from one to three to four to twelve- month injections.  New reimbursement rules create an opportunity for doctors to make more money on higher cost, long-term cancer treatments.  Be alert!  This might prompt possible switches from short to long- term therapies. 

While there are some patients who benefit from long-term treatments, many are better suited for short-term therapies and enjoy their regular doctor visits and lower co-pays. Why pay for a change in treatment that might not be in your best interests?

Take Control of Your Health

Unless it’s medically necessary to change your therapy, tell your doctor “no treatment switches this year” – especially if it means higher co-pays!  And if you think your doctor may have already switched your therapy, pay attention to the way the treatment is being administered.  If it’s different than what you’re used to then there may be cause for concern.

Patients’ Medical Needs Must Come First

If you feel your doctor is putting his interests before your medical needs, you should write or call Dr. Mark McClellan, CMS Administrator at 7500 Security Boulevard, Baltimore, MD 21244-1850, (877) 267-2323 or contact your U.S. senator or member of Congress (www.senate.gov or  www.house.gov) about this issue.  If you choose to write a letter, the FPCN can provide you with sample message points to assist you in crafting your message.  Since the FPCN is trying to track this issue, we would appreciate receiving a copy of your letter as well.

Ask them to warn Medicare carriers and physicians NOT TO abuse the loophole – a loophole that may encourage prostate cancer care decisions to be influenced by reimbursement rates.