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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ASCO's delegates to the American Medical Association’s (AMA) House of Delegates (HOD) will propose several resolutions during the policy-making body’s interim meeting, which will be held November 16-19, 2019. ASCO currently sends three delegates to the AMA HOD: Edward P. Balaban, DO, FACP, FASCO; Thomas A. Marsland, MD, FASCO; and Ray D. Page, DO, PhD, FACOI, FASCO. The society also has two alternate delegates to the HOD: Kristina L. Novick, MD and Steve Y. Lee, MD. ASCO’s Resident Fellow Section Delegate is Erin L. Schwab, MPH, BS, MD.
On November 1, the Centers for Medicare & Medicaid Services (CMS) released its final rule for reimbursement under the Hospital Outpatient Prospective Payment System (HOPPS) in 2020. ASCO is still analyzing the rule and will provide in-depth analysis for members as soon as possible. Based on a preliminary evaluation, key provisions in the proposed rule include:
Health insurers, employers, and pharmacy benefit managers (PBMs) have shifted a growing share of the costs for specialty prescription medicines to their patients and beneficiaries. Since insurer cost-sharing requirements for prescription medications (such as high coinsurance and deductible amounts) can be uniquely burdensome compared to other types of health care, pharmaceutical manufacturers regularly offer co-pay assistance—which can include co-pay cards or coupons—to help patients afford their prescriptions.
In a letter to leaders of the U.S. Senate and House of Representatives, ASCO, along with more than 100 other medical groups, urged Congress to protect patients from unanticipated, or “surprise,” medical bills that can occur when gaps in health insurance coverage lead them to receive care from out-of-network providers.
Rising health care costs, including escalating drug prices, have led to an increased focus by payers on strategies to guide the use of health care resources. As payers search for ways to control the rising cost of care, they often employ “utilization management" (UM) policies, which are payer-imposed practices that may restrict, limit, or deny coverage for certain treatments.
At the 2019 ASCO Advocacy Summit, ASCO members from 35 states held more than 160 Congressional meetings, urging Members of Congress to take action to advance policy priorities which improve patient access to cancer care, including clinical trials.
Senators Lisa Murkowski (AK), Doug Jones (AL), and Bill Cassidy (LA) introduced S. 2546, the Safe Step Act of 2019, in the U.S. Senate. If enacted into law, the bill would ensure patients with private insurance have reasonable protections against harmful step therapy practices.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a proposed rule that would loosen state reporting requirements and potentially threaten access to cancer care for Medicaid beneficiaries. ASCO believes all patients should have access to high-quality, high-value cancer care and is concerned that CMS’ proposal would jeopardize that access.
During ASCO's upcoming Advocacy Summit, oncology care providers will urge lawmakers to improve clinical trial access, protect patients from unnecessary care delays, ensure acess to potentially lifesaving medications, and foster continued success of the MACRA program. ASCO members are invited to participate virtually through the ACT Network.
The American Medical Association (AMA) and Manatt Health have released, “National Roadmap on State-Level Efforts to End the Opioid Epidemic,” an analysis identifying effective state policies against the national opioid epidemic.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the agency’s Request for Information (RFI) on Patients over Paperwork. ASCO’s comments provide the society’s perspective on improving the delivery of cancer care in a way that is beneficial for people with cancer and oncology professionals.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a proposed rule regarding Secure Electronic Prior Authorization for Medicare Part D. Under the proposal, clinicians would be able to complete prior authorizations for Part D prescriptions online and through a more streamlined process.
On August 9, ASCO submitted a comment letter to Alex M. Azar II, Secretary of Health and Human Services (HHS), regarding the proposed rule on Sec. 1557 of the Affordable Care Act (ACA)—Nondiscrimination in Health and Health Education Programs or Activities.