The Financial Impact of the Sequester Cut to Medicare Part B Drug Reimbursement in Community Oncology

摘要

the Medicare Modernization Act of 2003 established that the rate for payment of Medicare Part B drugs is the average sales price (ASP) of the drug plus 6%.4 However, this percentage was affected when the Balanced Budget and Emergency Deficit Control Act of 1985 was amended by the Budget Control Act (BCA) of 2011. BCA required payment reductions in federal expenses through a sequestration order then set by the Office of Management and Budget and subsequently mandated by President Barack Obama on March 1, 2013. On April 1, 2013, a 2% cut was implemented to Part B drug reimbursement. However, the sequester is taken off the top of the 80% paid by Medicare, bringing a drop in the ASP from 6% to 4.3% and a 28.4% drop in reimbursement for cancer medications (chemotherapy, immunotherapy, and supportive intravenous drugs) under Part B reimbursement.5