The Ripple Effect: Sequester’s Impact on Cancer Care

ACCCBuzz

by Matt Farber, Director of Provider Economics & Public Policy, ACCC

mjqny24-580x386According to a front page article in today’sWashington Post, the 2% cut to Medicare reimbursement is already having an effect on oncology offices across the country.  The article states that some practices have made the difficult decision to cut back on the number of Medicare patients they see, and one hospital has stated that they are preparing for an increase in Medicare patients.

The 2% cut to Medicare reimbursement affects all services billed to Medicare, including E&M codes, chemotherapy administration, hydration, and drugs and their overhead costs. Because many oncology drugs are reimbursed under Medicare Part B, the reduction in drug reimbursement from ASP+6% to ASP+4.3% is having a deleterious effect.

Prior to the sequester, providers were reimbursed average sales price (ASP)+6% for drugs covered under Medicare Part B. The “plus” percentage helps cover pharmacy overhead costs…

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