Oncologist organization sues to stop sequester cuts to cancer drug reimbursement

The Community Oncology Alliance plans to file a lawsuit in U.S. District Court for the District of Columbia to stop HHS and the Office of Management and Budget from applying Medicare sequester cuts to reimbursement for Part B drugs. (Sarah Stierch/CC BY 4.0)

A national nonprofit organization representing oncologists filed a lawsuit on Wednesday against the Trump administration calling for an end to "illegal" cuts that impact cancer drug reimbursement.

The Community Oncology Alliance filed the suit (PDF) in the U.S. District Court for the District of Columbia, saying the Centers for Medicare & Medicaid Services should stop applying a 2% sequester cut to Medicare Part D drug reimbursement. The application of that cut to Part B reimbursement is "illegal and unconstitutional," the COA said in a statement. 

"What's interesting about Part B drug reimbursement, as opposed to any other Medicare reimbursement, is that Medicare Part B reimbursement to physicians is defined in law. That rate is defined in law as average sales price plus 6%," said Ted Okon, executive director of COA, in an interview with FierceHealthcare. He was referring to the Medicare Modernization Act of 2003. "It's an overreach of the executive branch in terms of basically bypassing the Congress," Okon said. 


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