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US oncologists group files lawsuit to stop cuts on cancer drug reimbursement

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US oncologists group files lawsuit to stop cuts on cancer drug reimbursement

The Community Oncology Alliance filed a case in the U.S. District Court for the District of Columbia to stop the government from cutting down cancer drug reimbursements.

The lawsuit, filed against the U.S. Department of Health and Human Services and the White House Office of Management and Budget, is asking the court to stop the Centers for Medicare and Medicaid Services from implementing a 2% sequester cut to part B drug reimbursement.

Part B drugs are medicines administered in the doctor's office or outpatient healthcare clinics.

The sequester cuts are mandatory budget cuts that have been implemented since 2013 and are to continue through 2017. The non-profit organization claimed the cuts harmed patients, wiped out the country's independent cancer care system, and cost billions in unnecessary healthcare spending.

According to the lawsuit, the sequester cut to Medicare part B drug is "unconstitutional and illegal" because it bypassed a 2003 law. The Congress had fixed the reimbursement for these drugs at 6% plus the average sales price through Medicare Modernization Act of 2003. But due to the sequester cut, part B drug payments were lowered to 4.3% plus the average sales price, the COA said in a press release.

The cuts have created problems for cancer patients since most of the independent community-run clinics have had to shut down or were acquired by big hospital chains, increasing costs for patients. According to a 2018 COA report, about 135 independent community cancer clinics had to close, while about 190 clinics were acquired by hospitals since the mandatory budget cuts were implemented.

The group also sent a letter to HHS Secretary Alex Azar explaining the case.

"We are filing this lawsuit on behalf of the millions of Americans who face cancer and should be able to get high-quality, affordable, cancer care close to home. The sequester has been one of the biggest reasons why they can't do that, and it is time for this to stop," COA President Jeff Vacirca said.

"Filing this lawsuit was a last resort after numerous meetings, discussions, and letters to HHS and OMB that went nowhere. We had hoped that the current Administration would have fixed what is a constitutional violation that is clearly harming seniors with cancer," said Ted Okon, executive director of the COA.

Washington, D.C.-based COA is a non-profit organization that represents more than 5,000 independent, community-based oncologists and advocates for community oncology practices and patients.