The Ripple Effect: Sequester’s Impact on Cancer Care

Posted in ACCC News, Advocacy, Cancer Care, In and Around Washington, DC by ACCCBuzz on April 4, 2013

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

mjqny24-580x386According to a front page article in today’s Washington 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 such as mixing, storage, and disposal. With the drop in reimbursement to ASP+4.3%, physicians are not being reimbursed enough to cover their costs related to the purchasing and delivering these drugs.

The best way to push back against these cuts is to raise the volume with lawmakers about the effect these cuts are having on cancer patients and their providers. ACCC would like to know if you have made any changes to your practice due to the sequestration. If you have, please contact Matt Farber at

Let’s work together to try and solve this issue.

2 Responses

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  1. […] are impacted disproportionally because of the way care is reimbursed.  In addition to services, the 2% sequester cuts are applied to drugs, which have fixed costs. Given the high cost of cancer care therapies, the sequester is putting […]

  2. wernerschwartz said, on April 26, 2013 at 12:58 am

    Reblogged this on wernerschwartz.

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