Oncologists sue government to stop reimbursement cuts

The Community Oncology Alliance (COA) has filed a lawsuit to prevent HHS and the White House Office of Management and Budget (OMB) from using sequestration to slash reimbursement for Medicare Part B drugs. "We are filing to seek an injunction ...

The Community Oncology Alliance (COA) has filed a lawsuit to prevent HHS and the White House Office of Management and Budget (OMB) from using sequestration to slash reimbursement for Medicare Part B drugs. "We are filing to seek an injunction ... because we have exhausted all possibilities in stopping what is an unconstitutional application of the 2% sequester cut to Part B drug reimbursement," COA said in a letter to HHS Secretary Alex Azar. Sequestration is an automatic reduction to federal government spending that happens because Congress was unable to negotiate a balanced budget in 2011. Sequestration has been extended at least four times since it was introduced, and the current sequester is slated to last through 2027. The impact of this has pummeled community oncology practices and seriously harmed cancer patients, especially older Medicare beneficiaries, COA argues. Hundreds of community oncology practices have shuttered or have merged with hospitals, where administration of cancer care is more expensive than it is in independent practices. This means that access to cancer care may be compromised, particularly in rural or underserved areas, because patients cannot find or afford treatment. In 2004, 84% of cancer care was delivered in independent community cancer clinics; the rest was administered in the outpatient hospital setting. This has now dropped to a little over 50%, a shift that was driven by the sequester cut to Part B drug reimbursement in 2013, COA says.