OBR Daily Commentary

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Study: Community Oncology Practices Have Lost $78 Million Due to Medicare Sequester

(COA) Aug 29, 2018 - Community oncology practices have lost $78 million as a result of the ongoing Medicare sequester cut to reimbursement for Part B drugs. This amounts to practices losing an average of more than $847,000 each due to the sequester cut, which has driven an increase in the number of closings and rate of closure of community oncology practices in the United States. Sequestration is an automatic cut to Federal government spending triggered because Congress was unable to negotiate a balanced budget in 2011. The blunt budget cutting gimmick has been extended multiple times, with the current sequester scheduled to continue through 2027. Beginning in 2013, the Centers for Medicare & Medicaid Services (CMS) began to apply a 2% budget sequester cut to all Medicare Part B reimbursement, including for drugs. The study found that all community oncology practices experienced a significant impact from sequestration. Examining data and reimbursement over a 27-month study period from January 2016 to March 2018, the authors found that at the beginning of 2016, each practice, on average, experienced an approximate 28% to 31% loss due to sequestration. This remained steady for large practices, while the small and medium practices began to experience more impact (38.4% and 34.7%, respectively). The overall average loss was 32% in the first quarter of 2018.

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Ted Okon (Posted: August 29, 2018)

quotesVery important analysis conducted by Dr. Lucio Gordan and fellow researchers. Shows the adverse impact that the sequester cut has had on community oncology practices. It's staggering to realize how much these practices have lost. The sequester cut applied to Medicare Part B drugs is illegal, which is why COA is suing the federal government.quotes

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A Little-Known Windfall for Some Hospitals, Now Facing Big Cuts

(New York Times/TheUpshot) Aug 29, 2018 - Most hospitals are nonprofit and justify their exemption from taxation with community service and charity care. But the Trump administration could require some of them to do more to help the poor, and the hospitals that are in the cross-hairs are those benefiting from an obscure drug discount program known as 340B.

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Ted Okon (Posted: August 29, 2018)

quotesVery good article in the New York Times that explains how the 340B drug discount program has mutated from its intended purpose. The program has become a financial windfall for many hospitals. I simply can't understand why hospitals using the program correctly to help those in need let other hospitals drag down this critical safety net program.quotes

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COA Files Lawsuit Against Federal Government to Stop Sequester Cut to Cancer Drug Reimbursement

(COA) May 31, 2018 - The Community Oncology Alliance (COA) has filed a lawsuit in the U.S. District Court for the District of Columbia to stop the United States Department of Health and Human Services (HHS) and the White House Office of Management and Budget (OMB) from applying the Medicare sequester cut to reimbursement for Part B drugs.

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Ted Okon (Posted: May 31, 2018)

quotesIt is very disappointing that this Administration would not undo the unconstitutional mistake of the previous Administration applying the sequester cut to Medicare Part B drug reimbursement. This legal action was the last resort of the COA Board.quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...