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Rep. Kind Leads Bipartisan Charge to Get Answers from CMS on How to Protect Cancer Patients’ Access to Health Care

Contact: Peter Knudsen, Phone: 202-225-5506, Peter.knudsen@mail.house.gov

 

Washington, D.C. – U.S. Congressman Ron Kind (D-WI), Congressman Pete Sessions (R-TX), Congressman Gene Green (D-TX), Congressman Michael C. Burgess, M.D. (R-TX), Congresswoman Allyson Schwartz (D-PA), and Congressman Ed Whitfield (R-KY) led a bipartisan group of more than 100 of their House colleagues in sending a letter to the Centers for Medicare and Medicaid Services (CMS) asking for information regarding its implementation of the two percent sequester cut to Medicare payments to providers. The lawmakers expressed particular concern for its impact on Medicare Part B drugs – specifically chemotherapy and other specialty infusible drugs.

“We’re calling on CMS to do whatever they can to ease the burden of the sequester on people bravely fighting cancer,” said Kind. “We need to take action now, before more patients lose access to life-saving cancer drugs.”

The letter urged CMS to clarify to Congress both its statutory authority to reduce Medicare Part B drug reimbursement and its understanding of Office of Management and Budget (OMB) guidance directing federal agencies to use any available flexibility when implementing the sequestration spending cuts to reduce operational risks and minimize its impact on the American people. Moreover, the bipartisan letter challenged CMS to use what flexibility it has available to direct the cuts away from patients.

The pricing for cancer drugs covered under Medicare Part B is a formula – Average Sales Price (ASP) plus six percent – intended to reimburse cancer clinics and other providers for their drug acquisition costs at average market rates. This reimbursement formula is comprised of both the fixed cost of the drug – ASP – and an additional physician services payment – six percent – that covers costs for inventory, facilities, storage, handling and waste disposal associated with these drugs.

 

 

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