Medicare Reimbursement Updates
On April 9, Representative Renee Ellmers (R-N.C.) introduced the Cancer Patient Protection Act of 2013. This bill seeks to reverse the sequester cuts that are being applied to physician administered cancer care drugs.
Beginning on April 1, 2013, the 2% sequestration reduction on Medicare physician payments is being applied to physician services and physician administered drugs. The application of the 2% cut to the reimbursement rate for cancer care drugs have forced some cancer clinics to stop treating Medicare patients. Passage of legislation is necessary to stop the cuts to cancer care, as CMS has stated that they do not have the authority to do so. Representative Ellmers’ bill also requires the retroactive restoration of payments on cancer care drugs that were reduced by the sequestration cuts.
STOP THE CUTS TO CANCER CARE
If you have not yet contacted your legislators, please take a moment to do so today! Every voice counts, tell your legislators how the sequester cuts threaten cancer care in the community setting. ION Solutions has made it very easy to contact your legislators, all you have to do is go to their Community Counts website, review or edit the letter provided, complete the privacy-protected registration form, then click on the ENACT CHANGE button. Your letter will be sent directly to your senator or representative.
Ask your legislators to sign-on to the Dear colleague letter to HHS, this letter asks CMS for information on their authority to reduce Medicare Part B drug reimbursement and asks CMS to use any flexibility it has to protect patient access to cancer care in the community cancer clinic by applying the sequester cut to just the 6% service payment and not the fixed drug cost. The deadline to sign on is Tuesday, April 16 so please reach out to your legislators!
ION Solutions’ website www.ourcommunitycounts.org also contains helpful advocacy resources such as a Physician Office Poster, Sequestration Talking Points, Sequestration Background Action Calls, and a Sequestration Patient Letter Template.
BILL TO REMOVE PROMPT PAY DISCOUNTS FROM ASP
H.R. 800 , introduced by Representative Ed Whitfield (R-KY) on February 15, would exclude customary prompt pay discounts from manufacturers to wholesalers from the average sales price (ASP) for drugs and biologicals under Medicare. This bill continues to gain sponsors with 48 cosponsors to date.
ION COMMUNITY COUNTS MONTHLY WEBINARS
Are you an ION member? Join me on ION’s monthly webinar – On May 23, we will outline the steps involved in Developing and Implementing a Billing Compliance Plan, On June 27, we will discuss What You Need to Know about ASCO’s QOPI Program, and on July 25, the topic will be Advocate for Your Practice & Patients: Opportunities to Participate in Medicare Policy Decisions.