Over the past 2 years I figured out that Medicare was overpaying for cancer chemotherapy. We had a big jump in residents choosing oncology for fellowship. (I know this is a cynical jump in logic, but it does make sense). It appears that congress has adjusted. Doctors fear lower Medicare drug payments will hurt cancer clinics: Scandal prompted bill’s writers to cut reimbursements

Congressional targeting of cancer clinics goes back about two years to investigations on Capitol Hill that revealed doctors obtained cancer-fighting drugs at bargain-basement prices but then received Medicare reimbursements for five times the amount they paid.

For instance, the House Energy and Commerce Committee in 2001 found that doctors paid $1.25 for 50 milligrams of Leucovorin, used in combination with chemotherapy to treat various forms of cancer. But Medicare reimburses the physicians $35.47 for that amount of Leucovorin.

Cancer doctors say the excess money goes to offset the cost of staffing and maintaining their clinics.

Medicare reimbursements for clinic expenses are insufficient, so doctors have come to rely on generous payments for drugs to keep their practices afloat, they say.

The overall effect remains opaque, but as usual, time will tell.