On May 30, 2018, the Community Oncology Alliance, Inc. (Alliance), a non-profit organization that advocates for community oncology practices, sued HHS, HHS Secretary Azar, the Office of Management and Budget (OMB) and OMB Director Mulvaney to stop the 2% sequestration cuts to Medicare Part B drug reimbursement that was implemented effective April 1, 2013. The complaint, filed in the federal district court in Washington, D.C., alleges that Congress never gave HHS authority to change the express statutory reimbursement formula set forth in the Medicare Modernization Act of 2003 by which Medicare Part B outpatient providers and suppliers (but not hospitals) are to be paid or reimbursed for Part B drugs. The complaint further asserts that by applying the sequestration order to Part B drugs, defendants have violated the Presentment Clause in the Constitution and caused an existing statute to be amended and altered outside of the normal lawmaking process.
The Alliance seeks a declaratory judgment declaring that the application of the sequestration to Medicare Part B drugs is invalid and cannot be applied to alter the Medicare Modernization Act reimbursement formula for Medicare Part B drugs.
A copy of the complaint is available here.
