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 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 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.
The Centers for Medicare & Medicaid Services (CMS) released a new national coverage determination (NCD) announcing that Medicare will now cover Food and Drug Administration (FDA)-approved Chimeric Antigen Receptor T-cell (CAR T-cell) therapy for certain patients with cancer.
On August 2, the Centers for Medicare & Medicaid Services (CMS) released the Hospital Inpatient Prospective Payment System (IPPS) final rule for fiscal year (FY) 2020. The rule finalizes changes that will affect all U.S. hospitals, including:
On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for reimbursement under the Hospital Outpatient Prospective Payment System (HOPPS) in 2020. ASCO is still analyzing the proposal and will provide more information to members as soon as possible. Based on a preliminary analysis, key provisions in the proposed rule include:
Annual HOPPS Update
On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B payment policies, including proposals related to the Quality Payment Program (QPP), online ahead of publication in the Federal Register on August 14.
In early July 2019, 14 out of the 16 members of the House GOP Doctors Caucus sent a letter to Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma requesting that their agencies reconsider a policy allowing Medicare Advantage plans to use step therapy.
President Trump recently signed an executive order, “Improving Price and Quality Transparency in American Health Care to Put Patients First,” aiming to provide patients with more transparent information about the price and quality of health care services so that patients can make better-informed decisions about their care.
The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule to update and streamline the prior authorization process under Medicare Part D. The proposal aims to improve access to prescription medications for Part D beneficiaries and alleviate administrative burden for providers. Under the proposal, clinicians would be able to complete prior authorizations for Part D prescriptions online and through a more streamlined process. ASCO supports efforts to improve the prior authorization process for patients and providers, including electronic prior authorizations.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the 2020 Hospital Inpatient Prospective Payment System (IPPS) proposed rule. ASCO’s comments focus on appropriate coverage and reimbursement for Chimeric Antigen Receptor T-Cell Therapy (CAR-T) therapies, the need to address disparities between rural and urban hospitals, and implementation of meaningful quality measures to improve cancer care for patients and providers.
A recent American Medical Association (AMA) report on opioids highlights how provider mandates—on training, prior authorizations—have not had a significant impact on curtailing the opioid epidemic. According to the Opioid Task Force 2019 Progress Report, prescription opioid-related mortality may be leveling off, however deaths from heroin and illicitly manufactured fentanyl and fentanyl analogs are at an all-time high. Instead, the report calls on policymakers to address the opioid epidemic with policies to promote evidence-based treatment.
On June 5, Members of Congress introduced new, bipartisan legislation that would streamline and standardize prior authorization requirements in Medicare Advantage (MA) plans. The bill, entitled “Improving Seniors’ Timely Access to Care Act of 2019,” (H.R. 3107) would improve the prior authorization process in MA plans by requiring “real time” authorizations for routinely approved services. The bill was introduced by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger Marshall (R-KS), and Ami Bera (D-CA). ASCO endorsed the legislation and applauds Representatives Reps.
On May 16, the Centers for Medicare & Medicaid Services (CMS) released a final rule on drug coverage policies. After receiving feedback from the American Society of Clinical Oncology (ASCO) and other stakeholders, CMS did not finalize a proposal that would have impeded access to drugs within Medicare Part D’s Six Protected Classes. The agency did, however, finalize a proposal to allow the use of step therapy for protected class prescription drugs under Medicare Advantage and Part B—despite stakeholder concerns.
The American Society of Clinical Oncology (ASCO) applauds the Centers for Medicare & Medicaid Services (CMS) for listening to ASCO and other stakeholders by not finalizing a proposal that would have significantly impacted access to drugs within the Six Protected Classes.