Congress Should Continue Suspension of Medicare Sequester
Infusion Providers Alliance
The Infusion Providers Alliance is the leading voice for in-office and freestanding ambulatory facility providers of drug infusion services. Alliance members are committed to preserving the integrity of the provider-patient relationship in a manner that delivers exceptional care to patients at a value to the health care system.
Our members have facilities located in communities across the nation, each of which offers a more convenient, more efficient and less expensive alternative for patients than receiving their infusions in the hospital setting. These facilities serve as critical access points of care for patients and save tremendous dollars for commercial and government payers alike while also lowering out of pocket costs for beneficiaries.
The Infusion Providers Alliance mission is to serve as a thought leader and to educate on issues critical to safeguarding, supporting, and strengthening provider directed, patient-focused access to in-office and freestanding ambulatory facility infusion services.
Suspension of Medicare Sequester Critical to Infusion Providers during Pandemic
The Budget Control Act of 2011 instituted a 2% sequestration cut to Medicare reimbursement for all providers, including reimbursement for Part B drugs from average sales price plus 6% (ASP+6%) to ASP+4.3%.
Part B products often necessitate special storage and handling protocols. The sequester reduced reimbursement without lowering these administrative burdens, putting financial pressures on many providers to administer these products.
Since that time, the Department of Health and Human Services has extended the COVID-19 Public Health Emergency three times, enabling the continuation of many CMS waivers. However, the suspension of the sequester must be enacted by Congress.
In the face of a vastly different health care landscape, sequester relief has been essential for enabling providers to continue to administer these critical medicines by keeping them financially whole. These providers include infusion centers, which remain a safe and cost-effective alternative to hospital-based administration as hospitals have seen an influx in COVID-19 cases.
Despite these efforts, 8% percent of physicians have closed their practices—almost 16,000 practices in total—due to COVID-19. An additional 8.000 practices plan to close in the next year. (1)
Our nation’s health care infrastructure continues to battle COVID-19 and recover from the suspension of elective procedures and in-person care due to the concern of potentially contracting the virus. These fears are especially relevant for patients receiving Part B products, as these individuals often have chronic conditions that leave them more susceptible to illnesses like COVID-19.
While much of the physician and provider community is focused on the E&M redistribution of resources under the fee schedule, suspending the sequester will assist all providers equally.