House Bill Supports Innovative Payment Models While Protecting People with Cancer and Their Providers

March 3, 2020

In a letter to Representatives Terri Sewell (AL), Adrian Smith (NE), Tony Cárdenas (CA), and John Shimkus (IL), the Association for Clinical Oncology (ASCO) conveyed its support for legislation the lawmakers introduced in the U.S. House of Representatives. The bill, H.R. 5741 or the Strengthening Innovation in Medicare and Medicaid Act, would create important guardrails to protect patients and their providers from unintended consequences that could come from testing new Center for Medicare and Medicaid Innovation (CMMI) payment models.

ASCO has long supported the transition from fee-for-service payment models to providing value-based care. The Association’s efforts to promote quality and value in cancer care delivery are reflected in ASCO’s Patient-Centered Oncology Payment Model and in the organization’s ongoing work to promote oncology-specific clinical pathways.

The Association also supports testing innovative new reimbursement models for cancer care but cautions that barriers to patient access and increased administrative burdens on practices can result from testing such models without appropriate safeguards in place. The unintended negative consequences of testing new oncology payment models could weigh especially heavy on smaller practices and patients in rural and underserved areas.

The Strengthening Innovation in Medicare and Medicaid Act would address many of ASCO’s concerns by creating important transparency requirements, rule-making protections, and hardship exemptions, that would offer oncologists more insight into CMMI’s processes, and protect both their patients and their practices from requirements that may result in undue economic hardship or loss of access to care.

Read the letter.

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