Doctors Say They Can't Absorb Loss From Lower Medicare Reimbursement

SETAUKET, N.Y. (CBSNewYork) — They were supposed to save money, but an unintended side effect of federal budget cuts has prevented that.

The most vulnerable Americans, elderly cancer patients, are being turned away from community clinics.

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They’re being denied chemotherapy because doctors said they can’t afford to absorb steep medicare cuts for chemotherapy drugs.

For Tom McCloskey, a painful change is coming to an already difficult routine. For nine years he’s been a chemotherapy patient at North Shore Hematology Oncology. But now, he’ll have to be treated at a hospital instead.

“It’s scary. I know how they treat me here and I know how they get treated in the hospital,” McCloskey told CBS 2’s Carolyn Gusoff.

He’s one of thousands of senior citizens with cancer being told by clinics to get their treatment elsewhere. At North Shore Hematology Oncology alone, 5,000 patients have been told they can no longer be treated. Patients blame lawmakers.

“Everyone of them should be fired,” said McCloskey.

They’re victims of sequester cuts from the bitter federal budget fight. Across the board cuts went into effect April 1st. Medicare saw only two percent cut, but when it comes to expensive chemo drugs, that is still big bucks.

Doctors said they can’t absorb the losses.

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“We couldn’t last for more than 3 to 6 months if we were to be in the red on all those drugs that now the reimbursement has gone down on,” said Dr. Jeff Vacirca, CEO Northshore Hematology Oncology.

A one-month course of chemo for one patient could cost $10,000 dollars. Medicare reimbursement will now fall about $200 short.

“It’s going to be a hardship to patients, their caregivers and really such an increased cost to society and to Medicare in the long run that it makes no sence to me,” Vacirca said.

It costs Medicare $6,500 more per patient for chemo administered in a hospital and patients will pay more out of pocket too — $650 more. Hospitals may also have a hard time absorbing the influx.

Meanwhile cancer care facilities are struggling with a decision: Continue to treat Medicare patients or potentially go broke.

They’re hoping Congress intervenes quickly.

Hospitals nationwide are figuring out how to respond.

On Long Island, administrators at Stony Brook University Hospital said they will care for cancer patients who cannot otherwise receive needed therapy.

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