ASCO strongly opposes the Centers for Medicare & Medicaid Services (CMS) decision to allow Medicare Advantage plans to employ step therapy across physician-administered and self-administered drugs under Medicare Part B and Part D.
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 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.
ASCO strongly opposes provisions in the 2019 Medicare Physician Fee Schedule (MPFS) proposed rule that could significantly cut cancer care resources that are needed to provide high-quality care to individuals with cancer
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.
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.
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.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a Request for Information (RFI) on Direct Provider Contracting (DPC) Models published on the Center for Medicare and Medicaid Innovation’s (CMMI) website in April 2018.
Members of ASCO's Leadership Development Program held a Hill Day to advocate for federal research funding, oral parity, step therapy, and other cancer policy priorities.
ASCO submitted comments to the Centers for Medicare & Medicaid Services on proposed changes to Medicare Advantage and Medicare Part D prescription plans for 2019. The comments included recommendations for updating prior authorization requirements as well as feedback on policies to address the national opioid epidemic.
ASCO is launching ASCO Practice Central, a new website that serves as an online information hub to help oncology professionals navigate a complicated and ever-changing practice environment—while providing high-quality patient care. The first ASCO website dedicated to the business of oncology, ASCO Practice Central provides a one-stop, centralized resource that oncology practices can use to address a wide range of practical issues, including changes to physician reimbursement, quality reporting requirements, and business management practices.
Congress passed the “Bipartisan Budget Act of 2018,” which funds the federal government through March 23, 2018, raises the federal budget caps for the next two years, and addresses several policies of importance to the cancer community.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s rule finalizing changes to the Quality Payment Program (QPP) in 2018. ASCO commends CMS for providing relief to physicians impacted by hurricanes in 2017, but urges the agency to remove Part B reimbursement from payment adjustments under the Merit-Based Incentive Payment System (MIPS) and to reconsider the weighting of ASCO quality programs in the MIPS Improvement Activities (IA) category.