WASHINGTON -- With cuts from sequestration forcing private cancer clinics to turn away Medicare patients, several fiscally conservative Republicans have joined Democrats in pushing the Obama administration to change policy.
Sen. Pat Toomey (R-Pa.), in an April 2 letter to Department of Health and Human Services Secretary Kathleen Sebelius, urged her to reconsider cuts in Medicare payments to providers of cancer drugs or to use her authority to soften the impact.
"It is imperative that Congress operate in a fiscally prudent manner," Toomey wrote. "While spending cuts are necessary to get our fiscal house back in order, I believe these cuts should be made in a thoughtful manner and have supported giving the Administration broader latitude to restructure spending reductions under the Budget Control Act. As you deliberate how to implement sequestration within the Medicare program, I ask that you exercise your discretion, to the degree permissible, to administer the cuts in a manner which protects beneficiary access to critical oncology services."
The letter, obtained in a Freedom of Information Act request, did not get a response from Sebelius, Toomey's office told The Huffington Post. The senator did not follow up, his office said.
Other lawmakers have expressed similar concerns about sequestration, underscoring how politically sensitive the cancer drug cut has become -- even for fiscal hawks like Toomey.
On April 19, dozens of House members, including several top Republicans, wrote the acting administrator of the Centers for Medicare and Medicaid Services about their concern that the cuts may violate the Medicare Modernization Act of 2003. That law sets prices for cancer drugs covered under Medicare Part B at the average sales price, plus 6 percent for administrative costs. The sequester cuts 2 percent off that reimbursement, according to physicians, primarily from the administrative side.
The lawmakers who sent the letter -- including National Republican Congressional Committee chairman Greg Walden (R-Ore.), former NRCC chairman Pete Sessions (R-Texas), and ranking Budget Committee member Chris Van Hollen (D-Md.) -- also encouraged Health and Human Services to explore whether it had the budget flexibility to lesson the blow.
"We are concerned about how this cut will be implemented and if there is any flexibility available to your agency in how the cut is applied to the payments," the congressmen wrote. "Unencumbered access to critical cancer medicines for Medicare beneficiaries is a top priority for us and we would like to work with you to find a path forward that does not result in cancer patients being turned away by their oncologists."
The mounting pressure to change sequester cuts to Medicare payments for cancer drugs has not yet reached the critical mass that would suggest a fix is near. Despite a number of stories of private clinics turning away Medicare patients (who are often treated at local hospitals), Congress has moved to address other sequester-related issues first, including the furloughing of meat inspectors and flight controllers. According to The Hill: "Sebelius has said the administration does not have the power on its own to soften the cuts to cancer clinics."
Legislation has, however, been introduced to make a technical change to Medicare's reimbursement system so that cancer centers would get full payment for drugs provided.
With reporting by Jason Cherkis.
CORRECTION: An earlier version of this story misidentified Rep. Chris Van Hollen as the chairman of the House Budget Committee. He is the ranking Democratic member.