Oncology Med Positions for Rapid Expansion, Seeks to Add Prostate Brachytherapy to ASCs

PITTSBURGH, PA — Oncology Med, Inc., a Pittsburgh-based cancer treatment solutions group, says that it has seen a substantial increase in inquiries and demand for new prostate cancer brachytherapy programs by the ambulatory surgery center (ASC) market since the first of the year. The increase is based on January 1 changes and additions from the Centers for Medicare & Medicaid Services (CMS) to approved reimbursement codes for ASCs.

Beginning January 1, 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 ASC 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, PhD, 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 ASC get up and running for the treatment of prostate cancer in its center, 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.

Source: Oncology Med, Inc.

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