COA Holds Emergency Hill Day to Warn Congress on Medicare Sequester

Samantha DiGrande

Yesterday, community oncology leaders flooded the Hill to meet with Congress and the administration to warn them of the impact the Medicare sequester’s increased cuts and extension will have on cancer care nationwide.

Yesterday, community oncology leaders flooded the Hill to meet with Congress and the administration to warn them of the impact the Medicare sequester’s increased cuts and extension will have on cancer care nationwide.

The emergency Community Oncology Alliance (COA) fly-in was prompted by the momentum of the tax bill in both the US House and Senate. The bill proposes to raise the current sequester from 2% to 4%, as well as extend cuts at the end of the 10-year budget window.

In 2013, CMS enacted a 2% sequester payment cut to Medicare. The cut was originally intended to be an incentive to design an alternative budget savings package. The cut, signed into law in August 2011, set up the US cancer care system for consolidation and increased costs to seniors, Medicare, and taxpayers, says COA.

Since the sequester was enacted, the effect on the cancer care community has been felt across the nation. According to COA’s 2016 Practice Impact Report:

  • 91 cancer treatment clinics have closed—a 31.6% increase in treatment site closings
  • 130 independent community cancer clinics have merged into hospitals, which is a 27.7% increase in consolidation of independent practices into the more expensive hospital setting
  • The sequester cut to cancer drugs has driven costs up for seniors, Medicare, and taxpayers
  • The cost of the consolidation of cancer care into hospitals is estimated at: $2 billion to Medicare in the first full year (2014) $500 million to seniors for the same period

“We had over a dozen oncology leaders on the Hill yesterday talking about the devastating impact that this would have…not only would it be devastating, but it would be irresponsible of Congress,” Ted Okon, MBA, COA’s executive director, told The Center for Biosimilars® in an interview. “Regardless of whether this tax bill passes, we’ve been arguing all year that CMS in the prior administration should not have applied the sequester to Part B Medicare drugs. We’re at the point now that we’ve been working with Congress and talking to the current administration, and it remains to be seen what we’ll do next if they don’t either legislatively fix this, or if they don’t stop it from a regulatory standpoint.”

Jeff Vacirca, MD, president of COA and CEO of New York Cancer Specialists, also had a strong message for lawmakers. “Our elected officials need to understand that this sequester may seem like funny money to them but it is a slow bleed closing cancer clinics and forcing them into the waiting arms of more expensive hospital systems—especially those profiting off 340B. Congress needs to understand that their doubling down on the sequester and constantly extending it will result in community oncology practices being forced to shut their doors, which will cause access issues for patients and increase treatment costs as cancer care shifts to expensive hospitals,” said Vacirca in a statement.