Cancer clinics: Our cuts from sequester needed earlier remedy than FAA’s

Congress should have addressed deep cuts to cancer clinics before tackling airline delays caused by sequestration, people at several of those clinics said Friday.

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Both the House and Senate have now voted to restore funding that the Federal Aviation Administration lost through the automatic budget cuts known as “sequestration.” The bill is headed to President Obama’s desk.

Although delays in air travel affect lawmakers personally, cancer clinics say the cuts they are facing under the sequester are far more serious — and should have been a higher priority for Congress.

“I would invite anyone in Washington to come look my patients in the eye and tell them that waiting for a flight is a bigger problem than traveling farther and waiting longer for chemotherapy,” said William Nibley, a doctor at Utah Cancer Specialists in Salt Lake City.

Cancer clinics have seen their Medicare payments slashed under sequestration. They have had to turn away thousands of new patients, and some clinics say they will have to close their doors for good if the sequester cuts are not reversed soon.

Pundits have chided lawmakers for focusing primarily on sequester cuts that affect them personally — such as delayed flights and cancelled White House tours — while other, much more severe effects are allowed to continue.

"Unfortunately, this doesn’t (hit) home directly to members, as traveling does," said Ted Okon, executive director of the Community Oncology Alliance, which is aggressively lobbying Congress to soften the cuts to cancer clinics.

Okon said he has sympathy for the FAA employees who were furloughed — the FAA is one of a slew of federal agencies that docked employees’ hours and pay as a result of the sequester. He does not begrudge furloughed FAA workers their fix, but he said Congress needs to move quickly on cancer care, too.

"I think, frankly, that it received a lot of attention. It’s not the bigger hurt,” he said.

As cancer clinics turn away new patients, those patients are generally turning to hospitals — where treatment costs Medicare more than it would at a clinic. Hospitals also are usually more inconvenient for patients.

“Having to wait for a plane can be frustrating; having to wait for cancer treatment can be much more serious … If Washington can protect business travelers, they should protect cancer patients, too,” said Todd O'Connell, executive director of the Southeast Nebraska Cancer Center.

Rep. Renee Ellmers (R-N.C.) has introduced a bill to scale back the cuts to cancer clinics, which has roughly 50 cosponsors so far.

"We already have 50 bipartisan co-sponsors and I am hopeful that this bill will be expedited in the same way that the FAA bill was this week. We cannot afford to waste any more time."

Okon said he is encouraged by the support for Ellmers’ bill and hopes Congress will take up the proposal after lawmakers return from recess.

"I really wish that what would happen is that Congress would come back and in some way, shape or form, move that bill — cosponsor it, push it through," Okon said. "We’ve seen that they can do that with the FAA. We'd like to see the same thing done with cancer — to have that bill fast-tracked.”

Cancer clinics do not believe they should have been cut as deeply as they were, and have petitioned the federal Medicare agency to reconsider the way it applied the sequester to them. But administration officials have said there is nothing they can do.

"Clearly, an act of Congress is needed to change what’s happening in the cancer space,” Okon said.

Cancer clinics believe their budgets were cut excessively because of the way Medicare determines their payments. Medicare pays clinics the cost of the drugs they buy, plus 6 percent to cover the clinics’ administrative costs. And the drug costs are set by law.

When Medicare applied the sequester, it cut clinics’ entire payment. They argue that the cost of their drugs should have been exempt, and the cut should have only come from the additional 6 percent reserved for clinics. When the cut is applied to the entire payment, clinics say, every patient comes at a financial loss.

More than 120 House members signed a letter last week urging Medicare to reevaluate the way it has applied the sequester, but Okon said the most realistic option at this point is probably a bill requiring the agency to refocus the cuts.

Congress ought to step in, he said, given that leaving the cuts in place longer drives more patients to hospitals and further raises costs for Medicare.

"The logic of this escapes me, except for the fact that the administration can now say that the sequester is actually hurting,” Okon said.

While Congress has been accused of looking at the sequester’s effects through too selfish and personal a lens, the White House has been accused of implementing it politically — focusing cuts on programs that will directly affect lawmakers or attract a high public profile.

Just last week, Rep. Gregg Harper (R-Miss.) slammed the administration for furloughing air-traffic controllers while not instituting furloughs in the office that is implementing most of Obama’s signature healthcare law.