Budget Deal Passed by Congress Addresses Key Cancer Policy Issues

February 12, 2018

On February 9, Congress passed the “Bipartisan Budget Act of 2018,” which funds the federal government through March 23, 2018 and raises the federal budget caps for the next two years. The budget deal includes several key policies of importance to the cancer community:

Corrects MIPS to Exclude Part B Drug Reimbursement. The law includes an important correction to the Merit-based Incentive Payment System (MIPS) to ensure that payment adjustments under the program are not applied to Medicare Part B drug reimbursement. ASCO strongly advocated for this correction to ensure that patients with cancer continue to have access to care and potentially life-saving drugs under the Part B program. ASCO’s leadership on this issue included agency comments, ACT Network campaigns, support of Dear Colleague letters written in the House and Senate, direct lobbying, and letters to congressional leadership.

Increases Funding for Cancer Research. As part of the budget deal, Congress also agreed to increase funding for the National Institutes of Health (NIH) over the next two years by at least $2 billion, signaling a continued bipartisan commitment to biomedical research in the United States.

Makes Other Technical Amendments to the Quality Payment Program. The deal allows the Center for Medicare and Medicaid Services (CMS) to reweight the cost performance category to not less than 10 percent for the third, fourth, and fifth years of MIPS. ASCO will continue to work with Congress and CMS to ensure this category works in oncology care. The deal further allows the Physician Focused Payment Model Technical Advisory Committee (PTAC) to provide initial feedback regarding the extent to which alternative payment models meet criteria and an explanation of the basis for the feedback.

Eases Unnecessary Burden of Meaningful Use Programs. Another provision supported by ASCO, the deal removes the current mandate that meaningful use standards become more stringent over time. Physicians will no longer have to submit and receive a hardship exception.

Repeals the Independent Payment Advisory Board (IPAB). ASCO is pleased that Congress has repealed IPAB, a commission created by the Affordable Care Act with the authority to make targeted cuts to Medicare—including to physician payments. While the society supports the goal of addressing the cost and value of cancer care, ASCO had deep concerns with the structure and authority of IPAB and long advocated for its repeal.

Provides Emergency Medicaid Funds for Puerto Rico and the U.S. Virgin Islands. ASCO is also pleased that Congress increased Medicaid caps for Puerto Rico and the Virgin Islands by $4.18 billion and $142.5 million, respectively, and provided for 100 percent federal cost sharing for Medicaid in both territories. This important change will make it easier for patients with cancer affected by recent hurricanes to access cancer care.

Provides Funds to Address Opioid Epidemic. The bill provides an additional $6 billion to address the opioid epidemic in the United States.

The measure also includes a two-year extension of the Medicare sequester, which re-imposes budget caps on Medicare spending. ASCO will continue to work with Congress to ensure adequate reimbursement for cancer care.

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