Medicare – Oral Cancer News

Medicare patients with HSNCC fare better than younger counterparts

Source: www.ajmc.com Author: Jaime Rosenberg Patients of Medicare age have favorable outcomes when it comes to head and neck cancer, say new study findings published in Head & Neck. The researchers of the study write that their findings suggest many patients are waiting to seek cancer diagnosis or treatment until becoming eligible for Medicare. Deemed the “Medicare” effect, patients aged 65 years who had Medicare coverage had an increased incidence of head and neck squamous cell carcinoma (HNSCC) but were less likely to receive a late-stage diagnosis and had lower mortality rates compared with their slightly younger counterparts on Medicaid or who were uninsured. “Cumulatively, this suggests a backlog of undiagnosed head and neck cancers within the near-elderly population, which take advantage of their new Medicare benefits to be diagnosed at early stage, treated with more surgery, and go onto to have better survival,” explained the researchers. “Prior studies have demonstrated an increase in the utilization of basic medical services, including cancer screenings and general exams, after patients become eligible for Medicare.” HNSCC accounts for approximately 3% of new cancer diagnoses in the United States each year and is generally diagnosed in patients aged 60 to 70 years. With cases often found during routine physicals or after experiencing symptoms such as dysphagia or voice changes, the researchers highlighted the importance of access to both primary care doctors and specialists. Drawing on data from the Surveillance, Epidemiology, and End Results (SEER) database, the researchers found that patients aged 65 years had [...]

Oral Cancer Foundation News Team - A2023-06-03T06:29:24-07:00June, 2023|Oral Cancer News|

I know how lobbyists make sure Americans don’t get dental care–I was one of them

Source: Fortune Date: November 19th, 2021 Author: Wendell Potter As Members of Congress continue their debate on the Build Back Better Act, it’s distressing to see House Democrats ignoring what Americans say they want most out of the legislation: adding dental coverage to Medicare. If the dental benefit isn’t put back into the bill, lawmakers will have shown once again that they listen more to two powerful trade groups in Washington–America’s Health Insurance Plans(AHIP) and the American Dental Association (ADA)–than to their constituents. As someone who has been on both sides, writing talking points for insurers and, more recently, fighting the ADA’s efforts to kill other bills to expand access to dental care, I know these organizations well. And they usually get their way. A recent Morning Consult poll found that the number one thing Americans say they want out of the reconciliation bill is Medicare dental coverage. That’s no surprise when you consider that millions of seniors lack dental coverage. Many suffer quietly with often excruciating pain caused by untreated–and often lethal–oral health disease. The main reason Medicare hasn’t covered dental care since its inception in 1965 (except when oral health problems become so severe they require hospitalization) is that organized dentistry staunchly opposed it. The dental lobby insists that any additional dental coverage should be restricted to the poorest Medicaid recipients. However, its main concern–as it was 56 years ago–is that Medicare would not reimburse dentists to their satisfaction. The ADA’s lobbyists, in essence, are placing the financial [...]

Charlotte Parker2021-12-21T12:29:10-07:00December, 2021|Oral Cancer News|

Hospitals required to post all prices online beginning January 1

Date: 12/26/18 Source: KATV Author: Associated Press WASHINGTON (AP) — Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday. The program is also starting a comprehensive review of how it will pay for costly new forms of immunotherapy to battle cancer. Seema Verma, head of the Centers for Medicare and Medicaid Services, said the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care. “We are just beginning on price transparency,” said Verma. “We know that hospitals have this information and we’re asking them to post what they have online.” Hospitals are required to disclose prices publicly, but the latest change would put that information online in machine-readable format that can be easily processed by computers. It may still prove to be confusing to consumers, since standard rates are like list prices and don’t reflect what insurers and government programs pay. Patients concerned about their potential out-of-pocket costs from a hospitalization would still be advised to consult with their insurer. Most insurance plans nowadays have an annual limit on how much patients must pay in copays and deductibles — although traditional Medicare does not. Likewise, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital’s payments on how good a job they do. Using electronic medical records remains a cumbersome task, and [...]

Charlotte Parker2019-01-02T12:52:16-07:00January, 2019|Oral Cancer News|

This Is Why Your Drug Prescriptions Cost So Damn Much

Source: www.motherjones.com Author: Stuart Silverstein When the Republican-controlled Congress approved a landmark program in 2003 to help seniors buy prescription drugs, it slapped on an unusual restriction: The federal government was barred from negotiating cheaper prices for those medicines. Instead, the job of holding down costs was outsourced to the insurance companies delivering the subsidized new coverage, known as Medicare Part D. The ban on government price bargaining, justified by supporters on free-market grounds, has been derided by critics as a giant gift to the drug industry. Democratic lawmakers began introducing bills to free the government to use its vast purchasing power to negotiate better deals even before former President George W. Bush signed the Part D law, known as the Medicare Modernization Act. All those measures over the last 13 years have failed, almost always without ever even getting a hearing, much less being brought up for a vote. That's happened even though surveys have shown broad public support for the idea. For example, a Kaiser Family Foundation poll found last year that 93 percent of Democrats and 74 percent of Republicans favor letting the government negotiate Part D prescription drug prices. "I mean, how in the world can one explain that the government actually passed a law saying that you can't negotiate prices?" It seems an anomaly in a democracy that an idea that is immensely popular—and calculated to save money for seniors, people with disabilities, and taxpayers—gets no traction. But critics say it's no mystery, given the [...]

Charlotte Parker2016-10-21T11:17:17-07:00October, 2016|Oral Cancer News|

The Cost of Cancer Drugs

Source: www.cbsnew.comAuthor: Lesley Stahl The following is a script of "The Cost of Cancer Drugs" which aired on October 5, 2014, and was rebroadcast on June 21, 2015. Lesley Stahl is the correspondent. Richard Bonin, producer. Cancer is so pervasive that it touches virtually every family in this country. More than one out of three Americans will be diagnosed with some form of it in their lifetime. And as anyone who's been through it knows, the shock and anxiety of the diagnosis is followed by a second jolt: the high price of cancer drugs. They are so astronomical that a growing number of patients can't afford their co-pay, the percentage of their drug bill they have to pay out-of-pocket. As we first reported in October, this has led to a revolt against the drug companies led by some of the most prominent cancer doctors in the country. Dr. Leonard Saltz: We're in a situation where a cancer diagnosis is one of the leading causes of personal bankruptcy. Dr. Leonard Saltz is chief of gastrointestinal oncology at Memorial Sloan Kettering, one of the nation's premier cancer centers, and he's a leading expert on colon cancer. Lesley Stahl: So, are you saying in effect, that we have to start treating the cost of these drugs almost like a side effect from cancer? Dr. Leonard Saltz: I think that's a fair way of looking at it. We're starting to see the term "financial toxicity" being used in the literature. Individual patients are going into [...]

Oral Cancer Foundation News Team - A2015-06-22T11:00:30-07:00June, 2015|Oral Cancer News|

Oral cancer patient fights Medicare for coverage

Source: Dr.Biscuspid.com By Donna Domino, Features Editor November 6, 2012 -- Hank Grass has so far successfully fought his submandibular cancer. But the retired policeman is now facing bankruptcy in his losing battle to get Medicare to cover the oral surgeries, dental treatments, and dentures he needs following radiation treatment. The 77-year-old had his salivary gland removed after doctors found cancer at the base of his tongue three years ago. But the radiation and chemotherapy damaged his teeth and gums so much that he had to have all but three of his bottom teeth extracted. Recently, Grass needed periodontal surgery to treat an infection he developed in his mandible from radiation treatments. After Hank Grass developed submandibular cancer, radiation therapy caused osteoradionecrosis, requiring the extraction of all but three of his bottom teeth. All images courtesy of Hank Grass. So far, Grass has spent $8,000 for the dental treatment and dentures, but Medicare won't reimburse him, saying his dental work was not medically necessary and is cosmetic. And since Medicare has refused payment, Grass' insurance company also has refused to cover the dental procedures. "I've been through a living hell," he told DrBicuspid.com. "We're pinching pennies; we're in bankruptcy." Five doctors -- including his dentist, oncologist, oral surgeon, and the doctor who administered chemotherapy -- submitted letters confirming that Grass' dental procedures were directly related to his cancer treatments. But it was to no avail, he said. "You don't have to be a rocket scientist to look at all the [...]

Charlotte Parker2012-11-07T12:40:04-07:00November, 2012|Oral Cancer News|

It Costs More, but Is It Worth More?

Source: The New York Times- Opinion Pages By EZEKIEL J. EMANUEL and STEVEN D. PEARSON If you want to know what is wrong with American health care today, exhibit A might be the two new proton beam treatment facilities the Mayo Clinic has begun building, one in Minnesota, the other in Arizona, at a cost of more than $180 million dollars each. They are part of a medical arms race for proton beam machines, which could cost taxpayers billions of dollars for a treatment that, in many cases, appears to be no better than cheaper alternatives. Proton beam therapy is a kind of radiation used to treat cancers. The particles are made of atomic nuclei rather than the usual X-rays, and theoretically can be focused more precisely on cancerous tissue, minimizing the danger to healthy tissue surrounding it. But the machines are tremendously expensive, requiring a particle accelerator encased in a football-field-size building with concrete walls. As a result, Medicare will pay around $50,000 for proton beam therapy for a patient with prostate cancer, roughly twice as much as it would if the patient received another type of radiation. The higher price would be worth it if proton beam therapy cured more people or significantly reduced side effects. But there is no evidence showing that this is true, except for a handful of rare pediatric cancers, like brain and spinal cord cancer. For children, the treatment does a better job of limiting damage to normal brain cells and reducing the [...]

Charlotte Parker2012-08-28T09:24:52-07:00August, 2012|Oral Cancer News|

Study: Oral cancers take financial toll

Source: Dr.Biscuspid.com April 26, 2012 -- The cost of treating individuals with oral, orapharyngeal, and salivary gland cancers is significant, particularly for patients who undergo all three forms of treatment, according to a new study by Delta Dental of Michigan's Research and Data Institute. And for many that is only the beginning of the financial impact of the disease. The project, which involved Thomson Reuters, Delta Dental of Wisconsin, Vanderbilt University, and the University of Illinois at Chicago College of Dentistry, began in March 2010. It is the first retrospective data analysis of a large number of head and neck cancer patients in the U.S. analyzing direct and indirect costs and comparing those costs to a matched comparison group, according to the authors (Head Neck Onc, April 26, 2012). Using data from the 2004-2008 Thomson Reuters MarketScan Databases: Commercial Claims and Encounters Database, Medicare Supplemental and Coordination of Benefits Database, Medicaid Multi-State Database, and the Health Productivity and Management Database, the researchers retrospectively analyzed claims data of 6,812 OC/OP/SG patients with employer-sponsored health insurance, Medicare, or Medicaid benefits. They found that, on average, total annual healthcare spending during the year following diagnosis was $79,151, compared with $7,419 in a group comprising similar patients without these cancers. They also found that the average cost of care almost doubled when patients received all three types of treatment: surgery, radiation, and chemotherapy. Healthcare costs were higher for oral cancer patients with commercial insurance ($71,732, n = 3,918), Medicare ($35,890, n = 2,303), and [...]

Charlotte Parker2012-04-27T10:16:48-07:00April, 2012|OCF In The News, Oral Cancer News|

Dental Care Denied by Medicare Turns into Major Lawsuit

Source: Dr.Bicuspid.com Medicare's refusal to cover extensive dental treatment that is often needed to treat patients with diseases such as oral cancer and Sjögren's syndrome is unreasonable and arbitrary, according to a lawsuit pending in U.S. federal court. The litigation, originally filed in 2008 on behalf of one plaintiff, was recently amended by the Center for Medicare Advocacy (CMA) in the U.S. District Court for the District of Arizona against U.S. Health and Human Services Secretary Kathleen Sebelius on behalf of three Medicare beneficiaries who needed medically related dental care stemming from underlying medical conditions. Medicare policy, which excludes coverage of "routine" dental care, does cover dental services when they are "incident to and an integral part of" eligible medical care. Dental procedures that are covered include extractions in preparation of radiation treatment of neoplastic disease, reconstruction of ridges that are performed simultaneously with the surgical removal of oral tumors, and the wiring of teeth if done in connection with jaw fractures. "We have argued that this is a misinterpretation of the Medicare statute," said CMA attorney Sally Hart, who filed the suit. "We think that beneficiaries who require extensive dental services because of damage from Sjögren's syndrome, as well as cancer radiation treatment and other conditions that destroy the production of saliva, should not fall within the exclusion." CMS does not comment on pending litigation, CMS spokesman Tony Salters told DrBicuspid.com. Why coverage denied Each of the plaintiffs in the CMA lawsuit suffered a serious medical condition, resulting in [...]

Oral Cancer Foundation News Team - A2011-08-16T16:04:15-07:00August, 2011|Oral Cancer News|

Shortchanging cancer patients

Source: nytimes.com Author: Ezekiel J. Emanuel Right now cancer care is being rationed in the United States. Probably to their great disappointment, President Obama’s critics cannot blame this rationing on death panels or health care reform. Rather, it is caused by a severe shortage of important cancer drugs. Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens used to cure leukemia, lymphoma and testicular cancer. As Dr. Michael Link, the president of the American Society of Clinical Oncology, recently told me, “If you are a pediatric oncologist, you know how to cure 70 to 80 percent of patients. But without these drugs you are out of business.” This shortage is even inhibiting research studies that can lead to higher cure rates: enrollment of patients in many clinical trials has been delayed or stopped because the drugs that are in short supply make up the standard regimens to which new treatments are added or compared. The sad fact is, there are plenty of newer brand-name cancer drugs that do not cure anyone, but just extend life for a few months, at costs of up to $90,000 per patient. Only the older but curative cancer drugs — drugs that can cost as little as $3 per dose — have become unavailable. Most of these drugs have no substitutes, but, crazy as it seems, in some cases these shortages are forcing doctors to use [...]

Oral Cancer Foundation News Team - A2011-08-07T20:40:33-07:00August, 2011|Oral Cancer News|