As MACRA Heads Toward Third Year, Congress Urged to Consider How Proposed CMS Changes Will Impact Medicare Beneficiaries with Cancer

July 31, 2018

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).

The statement notes ASCO’s appreciation for the committee’s continued oversight during MACRA’s multi-year implementation phase and strong support for the initial passage of MACRA as a replacement for the flawed Sustainable Growth Rate formula. ASCO also thanks the committee for passing a critical technical correction to MACRA in February 2018, which removed Part B drugs from the low volume threshold and scoring adjustments in MIPS.

ASCO further notified lawmakers that regulatory changes may impact the ability of high performing providers to receive the bonuses intended by MACRA. In the Quality Payment Program (QPP) proposed rule for 2019, the centers for Medicare & Medicaid Services (CMS) increased the significance of the cost performance category in MIPS, but the proposal lacks necessary updates to the program’s methodology.  ASCO has long called for a risk adjusted methodology to account for the severity and variation of high-cost therapies and the potential hospitalizations that are at times necessary to treat patients with cancer.

Additionally, the 2019 Medicare Physician Fee Schedule (MPFS) proposed rule would cut reimbursement for oncology services by 4 percent overall, decrease reimbursement for new Part B drugs, and overhaul evaluation and management (E&M) coding that could also harm practices caring for complex patients. Such reductions diminish changes Congress established under MACRA to reward providers who offer the highest quality cancer care, notes the ASCO statement.

Over the coming months, ASCO will be in touch with CMS as well as Congress about the impact of these proposals on cancer care.

Read the full statement, and keep an eye on ASCO in Action for all the latest cancer policy news.