Oncologists Sue HHS to Stop Cancer Drug Reimbursement Cuts

The Community Oncology Alliance (COA) has filed a lawsuit against the Trump Administration to stop a 2% cut to Medicare Part B reimbursements for cancer drugs, according to a court filing.

“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,” Jeff Vacirca, MD, FACP, president of COA and CEO of NY Cancer Specialists, said in a press release announcing the suit. “The sequester has been one of the biggest reasons why they can’t do that, and it is time for this to stop. I see the impact of the sequester cut to Part B drug reimbursement to patients and practices on a daily basis. Because of it, our country is left with less access to cancer care in communities—particularly in rural and underserved regions—as well as unnecessarily high spending to receive it in hospitals.”

The reimbursement cuts were enacted in 2013 as part of the Obama Administration’s federal sequester. COA called these cuts “illegal and unconstitutional,” noting that the Administration is bypassing current law under the Medicare Modernization Act of 2003 that sets reimbursement rates at list price plus 6%.

“The Administration has bypassed Congress and the law by lowering Part B drug payments to ASP plus 4.3%,” COA said. “As such, HHS and Office of Management and Budget (OMB) are violating the separation-of-powers doctrine of the Constitution. Simply put, the Executive Branch cannot amend legislation passed by Congress under the guise of executing the laws.”

COA explained in a letter to Alex Azar, Secretary of HHS, that the lawsuit was a last resort—noting that the CMS recently defended the reimbursement cuts in a letter to COA.

“The response we have received at HHS and OMB reflects more on the current Administration’s views on the policy of Medicare Part B drug reimbursement and not on correcting the prior Administration’s unconstitutional application of the sequester,” COA wrote in the letter to the HHS. “Bad policy has followed more bad policy with Part B as documented by how policy changes made in Washington are demonstrably adversely impacting cancer patients across the country. As a result, we are left with no other option but to pursue legal action.”

—David Costill

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