Sequestration Affects Medicare and Medicaid Reimbursements
White Plains, NY (Law Firm Newswire) May 22, 2013 - Payment reductions are expected for Medicare and Medicaid in light of sequestration cuts.
This March, the Centers for Medicare and Medicaid Services announced that the Medicare FFS Program (Part A and Part B) is slated for a reduction in payments due to the sequestration order which was recently signed into law. Health care suppliers and providers have been notified that reimbursements for claims that are filed for both dates-of-service and dates-of-discharge starting on April 1, 2013, will now have a 2 percent reduction in the amount that is reimbursed. This will also affect claims for orthotics, prosthetics and other medical supplies.
Legislators had stated that they attempted to protect Medicare from cuts as much as possible: while most programs faced a 7.8 percent cut, Medicare was only hit by 2 percent. But that 2 percent cut has fallen heavily on cancer patients, critics say. Oncologists are not able to change the cost of the drugs they use for cancer treatments in chemotherapy treatments; the 2 percent cut must be taken from overhead costs such as supplying and administering those medications.
Cancer-fighting drugs may cost as much as $15,000; for a clinic, absorbing 2 percent of that cost for every patient, for every course of their multi-course treatment, can be significantly detrimental to their ability to offer those services. The clinics that will likely be able to continue treating patients and meeting their own bills may be forced to cut back on the number of patients they treat. North Shore Hematology Oncology Associates based in Long Island, New York, for example, has just announced that they will no longer be able to treat approximately one-third of the 16,000 patients they have treated who have their care funded by Medicare.
While many Medicare patients who are being turned away by cancer clinics may have to get their treatments met at area hospitals, studies have found that patients pay an average of $650 more each year for cancer treatment when they receive that treatment solely from a hospital. The increased cost, critics point out, may not be affordable to many patients, leaving them with nowhere to turn.
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