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Medicare cancer project scrutinized

Last year, Medicare officials came up with a $300 million project to improve the quality of care for chemotherapy patients. While doctors were paid for participating in the program, 230,000 Medicare patients were charged for answering questions about their cancer.
/ Source: NBC News Investigative Unit

Last year, Medicare officials came up with a $300 million project to improve the quality of care for chemotherapy patients. While doctors were paid for participating in the program, 230,000 Medicare patients were charged for answering questions about their cancer.

Charles Warner is one of them.

"They were to ask me certain questions," he says.

Every time he received chemotherapy, Warner was asked three questions about side effects — assessing the severity of nausea, pain and fatigue he was experiencing — and that data was given to Medicare.

But two independent investigations found the project had so few guidelines, the data collected was virtually useless. One report concluded that the project was mostly designed to get more money to oncologists.

"It should've been quite obvious to them that it was a waste of taxpayers' money at any level of expenditure," says Sen. Charles Grassley, R-Iowa, and chairman of the Senate Finance Committee.

One problem: the amount doctors were paid — $130 per patient per day. Critics say that paying doctors $130 to ask three questions they ought to be asking anyway is absurd.

A senior Medicare official defends the spending.

"The payments were appropriate for what was going on in terms of the doctor's office, and the processes that they had to put in place in order to participate in this program," says Dr. Peter Bach, a senior advisor at the Centers for Medicare & Medicaid Services.

Investigators say the lack of guidelines left the project open to abuse. They found 110 doctors collected more than $270,000. One doctor in Florida collected more than $625,000.

Does Bach concede that some doctors abused the program?

"Those are clearly things that need to be examined," he says.

Not only that, but Medicare rules required cancer patients to pay $26 every day they were asked those three questions.

The Warners say that money matters.

"Twenty-six dollars is a lot of money!" says Patricia Warner, Charles' wife.

One of the critics of the program called it, essentially, a "boondoggle for oncologists."

"[It's] certainly not a boondoggle to put in place a system where we can monitor the quality of care and the quality of life of cancer patients in the Medicare program," says Bach.

Medicare officials insist the project was worthwhile. But oncologists told investigators they didn't believe it would lead to better care.