FAX #202 456-2461                          FAX #408 487-

DATE: November 11, 2008                 # OF PAGES: CMS Reply 6

                                                                               My Reply to CMS 7

MESSAGE:  The Medicare Modernization Act of  2003 is not being implemented as you intended.

Cancer treatment options previously available to Medicare patients have been removed by CMS MAC's Palmetto GBA, Noridian, and Trailblazer.  Each of these Medicare Providers have removed SBRT/CyberKnife as a treatment option for prostate cancer and other cancers.  CMS regulations require that the Medicare providers select the least restrictive coverage and these three Medicare Providers are not incompliance.

The failure of Palmetto GBA, Noridian, and Trailblazer will lower the quality of life for cancer patients and cost Medicare tens of millions of dollars of additional treatment cost.  Seldom is a new treatment less expensive but that is the case with the CyberKnife.

Please require CMS Medicare providers to follow the intent and requirements for your MMA 0f 2003

Best Regards

Fred