Medicare Cancer Patients Denied Chemo Under Sequester

Thursday, 04 Apr 2013 11:26 AM

By Lisa Barron

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Thousands of Medicare patients are being denied care at cancer clinics as a result of the sequester, a new report said Thursday.

Oncologists say they are unable to give patients expensive chemotherapy drugs due to the across-the-board federal budget cuts, which went into effect for Medicare on April 1, according to The Washington Post.

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Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York, told the newspaper that if his clinic treated those patients receiving the most costly drugs, “We’d be out of business in six months to a year,” he said. “The drugs we’re going to lose money on we’re not going to administer right now.”

Vacirca added: “It’s a choice between seeing these patients and staying in business.”

Vacirca’s clinics decided earlier this week to stop seeing one-third of their 16,000 Medicare patients.

Lawmakers limited most of Medicare to spending cuts of 2 percent, far less than the cuts to other government programs. But because cancer drugs must be given by a physician, they are paid by the Medicare program that covers doctor visits and is not exempt from sequestration.

The government usually pays oncologists for the sales price of a chemotherapy drug as well as an additional 6 percent to cover the cost of storing and administering the medication, but they say that now the entire 2 percent cut will have to come out of that 6 percent overhead.

“When I look at the numbers, they don’t add up,” Ralph Boccia, director of the Center for Cancer and Blood Disorders in Bethesda, Md., told the Post. “Business 101 says we can’t stay open if we don’t cover our costs.”

Cancer patients who are denied care at local clinics can go to hospitals for chemotherapy treatment, but that will cost the federal government an average of $6,500 more each year than care provided in a clinic, according to the Post. And Medicare patients, responsible for a portion of the bill, could wind up paying an average of $650 more in out-of-pocket-costs.

The Community Oncology Alliance, which advocates on behalf of hundreds of cancer clinics across the country, has sent letters to lawmakers urging them to exempt cancer drugs from the sequester or cut just 2 percent from the money they receive to give the medications.

“We’re hoping that something will change, as legislators see the impact of this,” said Boccia,” adding “I don’t think we could keep going, without a change, for more than a couple of months.”

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