Upton, Green Introduce Legislation to Improve Cancer Care
Bipartisan bill would fix prompt pay rates, ensuring efficient distribution of life-saving cancer care drugs
U.S. Rep. Fred Upton, R-St. Joseph, alongside U.S. Rep. Gene Green, D-Texas, introduced H.R. 1920, a bill that would ensure cancer patients across the country continue to have access to life-saving treatments and care. H.R. 1920 addresses a flawed Medicare reimbursement formula that results in some providers not being adequately paid for their services.
“Here in Michigan we have 19 dedicated cancer centers including the Lakeland HealthCare Marie Yeager Cancer Center in St. Joseph,” said Upton. “Our common-sense, bipartisan legislative fix corrects the Medicare reimbursement formula that currently threatens the distribution of cancer care drugs across the country. This will ensure patients continue to receive the highest quality cancer care available. I look forward to working with my colleagues on both sides of the aisle here in the House and in the Senate to move this bill forward.”
“The prompt pay discount is affecting the delivery of treatment to our seniors and having an adverse impact on physicians and their patients in communities across the country,” said Green. “This needed fix of the Medicare reimbursement formula will help maintain the type of robust provider network we need to ensure quality healthcare options for Medicare beneficiaries in the years to come.”
Community-based cancer centers provide treatment to more than 80 percent of the nation’s new cancer patients. Ensuring more appropriate payment amounts for cancer drugs under Medicare Part B would help protect these cancer centers. So-called “prompt pay” discounts are contractually provided terms from pharmaceutical manufacturers to drug distributors. Prompt pay discounts compensate distributors for the costs of shipping, handling, and distributing drugs to providers. Under current law, the inclusion of these discounts in Medicare’s payment formula artificially lowers reimbursement rates for providers, which harms patient access to high-quality care. H.R. 1920 would fix the Medicare reimbursement formula by removing customary prompt pay discounts from the calculation to ensure that providers receive fair reimbursement.
Other original co-sponsors of H.R. 1920 include Rep. Diana DeGette, D-Colorado, Rep. John Shimkus, R-Illinois, and Rep. Pat Tiberi, R-Ohio.
These bipartisan efforts enjoy the support of patient groups such as the Association of Community Cancer Centers, the National Patient Advocate Foundation, the American Society of Clinical Oncology, and the Community Oncology Alliance.