NY cancer center avoids Medicare reimbursement cut after $250k typo

CMS has decided not to pull $250,000 in Medicare reimbursement from Hematology-Oncology Associates of CNY, a cancer treatment center with locations across New York in Auburn, Camillus, East Syracuse and Onondaga Hill, according to a press release from Senate Minority Leader Charles Schumer, D-N.Y.  

Hematology-Oncology Associates participates in Medicare's Oncology Care Model, which is administered by CMS. When submitting annual performance data the cancer center used the incorrect value modifier. Instead of using "1P" to identify patient cases the cancer center used "lP."

CMS told Hematology-Oncology Associates its Medicare reimbursement would be reduced by $250,000 due to the error. The cancer center appealed the ruling, but CMS stood by its decision.

Mr. Schumer and Rep. John Katko, R-N.Y., sent a letter to CMS Administrator Seema Verma asking the agency to reconsider its decision. They argued the $250,000 cut in Medicare reimbursement due to the clerical error lacked common sense and was overly punitive.

Mr. Schumer and Mr. Katko announced Wednesday that CMS reversed its decision.

"Congressman Katko and I know how important Hematology-Oncology Associates of CNY's work is to this community and those suffering from severe medical conditions. This decision lacked common sense and we knew that we had to push CMS to reconsider," said Mr. Schumer.

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