On October 21, 2020, the Centers for Medicare & Medicaid Services (CMS) announced plans to delay the start date of the Radiation Oncology (RO) model until July 1, 2021. The change comes following stakeholder concerns—the Association for Clinical Oncology (ASCO) among them—about the challenges of implementing the model by the initial start date, January 1, 2021, during the COVID-19 pandemic.
ASCO in Action provides the latest news and analysis related to critical policy issues affecting the cancer community, updates on the Association for Clinical Oncology’s ongoing advocacy efforts, and opportunities for members and others in the cancer care community to take action.
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A letter from 160 Members of Congress to Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma made recommendations regarding the coming update to Evaluation and Management (E&M) services Current Procedural Terminology (CPT ®) codes (99202-99215) in 2021.
On October 1, 2020, the Department of Health and Human Services (HHS) announced $20 billion in new funding for providers through the Provider Relief Fund (PRF). Under this Phase 3 General Distribution allocation, providers that have already received PRF payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by COVID-19.
In a comment letter to the Centers for Medicare & Medicaid Services (CMS), the Association for Clinical Oncology (ASCO) expressed significant concerns that provisions in the 2021 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule have the potential to undermine access to cancer care for Medicare beneficiaries.
The Centers for Medicare & Medicaid Services (CMS) finalized the Radiation Oncology (RO) model, a mandatory payment model that requires participation from radiotherapy (RT) providers and suppliers that furnish RT services within randomly selected core-based statistical areas (CBSAs)—which are linked to ZIP Codes.
On September 13, President Trump signed an executive order (EO) aiming to address high prescription drug prices by tying payments for certain Medicare drugs to the costs the treatments sell for outside the United States (U.S.). According to the EO, prices for provider-administered drugs would be linked to a "most-favored-nation price" drawn from the lowest price among countries that have a similar per-capita gross domestic product.
On September 2, the Centers for Medicare & Medicaid Services (CMS) released updates to the Inpatient Prospective Payment System (IPPS) final rule for fiscal year 2021, including updates to Medicare payment policies and payment rates for most acute care hospitals. Notably, CMS finalized its proposal to establish a Medicare Severity Diagnosis Related Group (MS-DRG) for chimeric antigen receptor T-cell (CAR-T) services.
On September 17, the American Society of Clinical Oncology (ASCO) will host ASCO Practice Leadership: E&M Codes For 2021. During this free webinar, Allison Hirschorn, Senior Coding and Reimbursement Specialist, Clinical Affairs at ASCO, will review new information and changes regarding the office and outpatient Evaluation and Management (E&M) services Current Procedural Terminology (CPT ®) codes (99202-99215), which go into effect January 1, 2021.
On September 16, the Association for Clinical Oncology (ASCO) will be hosting its first ever completely virtual Advocacy Summit. Oncology care providers from across the United States will meet with Members of Congress and their staff by phone or video to advocate for policies that will improve access to high-quality, equitable care for people with cancer and ensure robust funding for cancer research.
On August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) released its third COVID-19-related interim final rule with comment period (IFC). Provisions from the rule impact hospital and laboratory COVID-19 reporting, as well as testing for Medicare beneficiaries. Comments are due 60 days after publication in the Federal Register.
On August 20, the American Society of Clinical Oncology (the Society), and its affiliate organization the Association for Clinical Oncology (the Association), will host ASCO Practice Leadership: 2021 MPFS & OPPS Rules, a free webinar that will review the 2021 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) proposed rules.
The Centers for Medicare & Medicaid Services released its 2021 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System proposed rules. The administration also released an accompanying Executive Order focusing on telehealth and rural healthcare.
On August 3, President Trump signed an Executive Order on Improving Rural Health and Telehealth Access aimed at increasing access to healthcare services in rural areas. The Centers for Medicare & Medicaid Services also released the Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System proposed rules for 2021.
The U.S. Department of Health and Human Services (HHS) posted the General and Targeted Distribution Post-Payment Notice of Reporting Requirements on the Provider Relief Fund (PRF), which aims to inform those who have received one or more payments from the PRF of the upcoming timeline for future reporting requirements.