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.
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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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.
ASCO recently submitted comments to the Senate Finance Committee hearing, “Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead.” The society’s comments focus on ASCO’s efforts to help members implement provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) in their practices and offered ideas for how Congress and the Centers for Medicare & Medicaid Services (CMS) can strengthen MACRA and the Medicare program in the years ahead.
ASCO recently submitted comments to the Department of Health and Human Services (HHS) in response to a proposed rule that would eliminate protection for manufacturer rebates on prescription drugs in the Medicare and Medicaid programs. The society’s comments express a shared concern over rising prescription drug costs and urge HHS to implement policies that make rebate arrangements transparent, while ensuring that efforts to address the problem don’t inadvertently lead to higher out-of-pocket costs for people with cancer.
"We strongly oppose the White House budget proposal for Fiscal Year (FY) 2020, which would stall our nation’s progress against cancer and impede access to needed care for the millions of Americans dealing with cancer. The proposal would make drastic, unprecedented cuts to the U.S. Department of Health and Human Services—which houses the National Institutes of Health (NIH), the National Cancer Institute (NCI), and the Centers for Medicare & Medicaid Services (CMS)."
In late January, ASCO notified members that some oncology practices and providers in the Merit-Based Incentive Payment System (MIPS) received inaccurate 2019 payment adjustments as a result of Medicare Part B drug costs incorrectly being included in the adjustments. CMS is now working to correct the payments. ASCO is in contact with the agency and will keep members informed as a solution is implemented. No action is required from MIPS participants at this time.
On January 31, ASCO joined more than 60 organizations in requesting the Centers for Medicare & Medicaid Services (CMS) to reverse its recent decision to limit coverage for Next Generation Sequencing (NGS). The organizations expressed concern that the decision will make it harder for patients to access medically necessary and relevant clinical tests, reducing the quality of their cancer treatment and care.
In a comment letter to the Centers for Medicare & Medicaid Services (CMS), ASCO urged the agency to protect patient access to necessary cancer care under Medicare Advantage (MA) and Medicare Part D. The comments were submitted in response to proposed changes to MA and Part D aimed at lowering drug prices.
ASCO, along with over 50 other organizations, signed a letter from the American Cancer Society Cancer Action Network to the Department of Health and Human Services urging the agency to reject proposed changes to Medicare Part D that could harm patient access to essential therapies, including cancer care.
The American Society of Clinical Oncology (ASCO), along with nearly 60 other organizations, joined the American Cancer Society Cancer Action Network (ACS CAN) in an advertising campaign urging the Department of Health and Human Services (HHS) and Congress to halt proposed changes to Medicare Part D’s six protected classes.