Here is some information that every cancer patient and taxpayer should know. If insurance companies and Medicare have their way, patients will no longer be able to see their oncologists and receive their chemotherapy treatments in the same office.
Reimbursement for administration of chemotherapy in physicians’ offices is slated to be cut. This will mean that patients will have to receive their treatments at hospitals rather than physicians’ offices because the reimbursement to the independent oncologists will be less than the cost to buy the drugs.
Treating patients in a hospital setting is not only inconvenient for the patients; it is much more costly, both to the insurance company and to the patient. Hospitals are able to buy drugs at a much reduced rate, known as “340B” pricing. The “340B” is governmental price fixing that allows the hospital to purchase drugs at a greatly discounted price — they are still able to charge the full price to the patients and their insurance companies.
This allows the hospital to greatly increase profits at the expense of patients, the respective insurance companies and Medicare. This practice was not the original intent of the law. The 340B pricing was to provide reduced prices for drugs for those patients who were either uninsured or underinsured. However, it has been greatly expanded, as the 340B drugs are given to all patients for huge revenue. Additionally, the cost to administer the drugs is more expensive in a hospital setting and much more inconvenient to the patients.
Reimbursement for the cost of chemotherapy drugs should be equal for the same services provided to a cancer patient regardless of where the service is delivered.
I want an answer as to why private insurance companies and Medicare would be willing to pay more for a service that, for years, was provided in offices at less cost and greater convenience to the patient and their families. Our state representatives do not have an answer.
Cancer patients and taxpayers should be asking the same question.
Gerald P. Miletello