The Center for Medicare & Medicaid Services (CMS) has released performance feedback for Merit-based Incentive Payment System (MIPS) clinicians who participated the 2017 performance year. Individual clinicians, groups, and eligible clinicians in certain Alternative Payment Models (APMs) can access a comprehensive overview of their MIPS final score, performance category details, and 2019 MIPS payment adjustment on the Quality Payment Program (QPP) website.
ASCO in Action regularly provides the latest news and analysis related to cancer policy news; see the following online articles. These updates provide snapshots of ASCO’s ongoing advocacy efforts, as well as opportunities for ASCO members and guests to take action on critical issues affecting the cancer community.
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In a comment letter to the Centers for Medicare & Medicaid Services (CMS) ASCO expressed significant concerns that provisions in the 2019 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule would undermine Medicare beneficiary access to cancer care due to reimbursement cuts based on site-of-service that fail to address systemic payment deficiencies for cancer care services under Medicare. ASCO urges CMS to forego implementing any additional utilization management strategies and instead enhance patient access to cancer care by facilitating participation in Advanced Alternative Payment Models (APMs) that use oncology clinical pathways to promote high-quality cancer care.
ASCO recently hosted a webinar offering an overview of the 2019 Medicare Physician Fee Schedule and Quality Payment Program proposed rule and its potential impact on individuals with cancer. ASCO strongly opposes aspects of the proposed rule that could significantly cut cancer care resources needed to provide high-quality care, and the society urges the Centers for Medicare & Medicaid Services (CMS) to abandon the proposal. ASCO members can still watch this important webinar and view the slides from the presentation.
ASCO leaders recently met with representatives from the Trump Administration to discuss the delivery of high-quality, high-value cancer care as the Administration implements its “blueprint to lower drug prices and reduce out-of-pocket costs.”
In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses the recently released Medicare Physician Fee Schedule (MPFS) proposed rule. The MPFS is a complete listing of all fees Medicare uses to reimburse doctors and other providers and suppliers under a fee-for-service payment system.
Representatives from ASCO and other medical specialty groups recently met with officials from the U.S. Department of Health and Human Services (HHS) to discuss the 2019 Medicare Physician Fee Schedule (MPFS). The meeting provided Administration officials with an opportunity to explain provisions in the 2019 MPFS proposed rule and for stakeholders to ask questions and express their concerns with the proposal.
ASCO submitted a statement to the U.S. House of Representatives Energy and Commerce Committee in conjunction with a subcommittee hearing on implementation of the Merit-Based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA).
On July 25, the Centers for Medicare & Medicaid Services released its 2019 Hospital Outpatient Prospective Payment System proposed rule. Among other provisions, the proposal would extend 2018 reimbursement cuts to the 340B Drug Pricing Program to include currently excepted, off-site hospital-affiliated outpatient clinics.
ASCO submitted a response to the Request for Information (RFI) that was included in the Trump Administration's “blueprint to lower drug prices and reduce out-of-pocket costs.” In a letter to Secretary of the U.S. Department Health and Human Services (HHS) Alex Azar, ASCO recommends a value-based approach to address rising drug costs and makes specific recommendations regarding the 340B Drug Pricing Program, reviving the Competitive Acquisition Program (CAP), moving drugs from Medicare Part B to Part D, and site neutrality proposals.
The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for 2019 Medicare physician reimbursement. CMS estimates that in 2019, the overall impact for the hematology/oncology specialty will be a 4 percent reduction in reimbursement and a 2 percent reimbursement reduction for radiation/oncology. These overall impacts reflect statutory adjustment factors, related to the Medicare Access and CHIP Reauthorization Act and Relative Value Units of CPT codes. It is important to note that the actual impact on individual physician practices will depend on the mix of services the practice provides.
ASCO submitted comments to U.S. House of Representatives Energy and Commerce Committee leadership in conjunction with a subcommittee hearing on the 340B Drug Pricing Program, “Opportunities to Improve the 340B Drug Pricing Program.” In writing to Committee leadership, ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, underscored ASCO’s appreciation for the committee’s continued efforts “to ensure the program addresses the needs of underserved patients—particularly their ability to access cancer care.”
The Centers for Medicare & Medicaid Services (CMS) is advancing the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration proposal to a public comment period and consideration for formal approval. If approved, the demo would waive Merit-Based Incentive Payment System (MIPS) requirements for clinicians who sufficiently participate in certain Medicare Advantage (MA) plans that involve assuming greater financial risk.
ASCO Practice Consulting Services & Support is expanding its offerings to include new clinical consulting services designed to help oncology practices standardize patient care, use their workforce efficiently, and transition patient care to a value-based care delivery model.
The Centers for Medicare & Medicaid Services (CMS) has provided an update on their review of a 2017 Wisconsin Physician Service Insurance Corporation (WPS)—a Medicare Administrative Contractor (MAC)—local coverage decision limiting off-label prescribing.
In the last decade there has been widespread adoption of clinical pathways in the United States healthcare delivery system. A high-quality oncology clinical pathway is a detailed, evidence-based protocol for delivering cancer care, including but not limited to anticancer drug regimens for specific patient populations.