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.  

On January 1, 2021, significant changes to the office and outpatient Evaluation and Management services Current Procedural Terminology (CPT ®) codes (99202-99215) will go into effect. Practices, physicians, and staff must prepare in advance for these changes to ensure a successful transition and avoid any disruption in reimbursement, but it can be difficult to know where to begin. To help the oncology community during this transition, American Society of Clinical Oncology has prepared a set of tools, and continues to develop educational materials, that explain the coming changes. 

The Association for Clinical Oncology (ASCO) submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program (CMS-5531-IFC) interim final rule. The rule clarifies earlier changes to Medicare reimbursement that promote the use of telehealth services during the COVID-19 pandemic and establishes reimbursement for audio-only evaluation and management (E&M) services at the same rate as telehealth and in-person E&M services.

The Centers for Medicare & Medicaid Services Innovation Center (CMMI) announced new flexibilities and adjustments to its current and future alternative payment models in response to the COVID-19 Public Health Emergency (PHE). Of note for the cancer community, CMMI made changes to the Oncology Care Model, such as payment methodology, quality reporting, and the timeline. 

A new infographic in the May 2020 print and online issues of JCO Oncology Practice (JCO OP) outlines paths to implementing the American Society of Clinical Oncology’s (ASCO) Patient-Centered Oncology Payment (PCOP) model—an alternative payment model designed to support transformation in cancer care delivery and reimbursement while ensuring that patients with cancer have access to high-quality care. Along with the infographic, the latest issue of JCO OP features an in-depth overview of recent changes to PCOP and two invited commentaries on the model.

The Centers for Medicare & Medicaid Services (CMS) has confirmed ASCO’s Survey on COVID-19 in Oncology Registry (ASCO Registry) is an acceptable clinical trial registry for the attestation of the high-weighted practice Improvement Activity (IA), “COVID-19 Clinical Trials related to the Emergency Response & Preparedness,” under the Merit-based Incentive Payment System (MIPS).

JCO Oncology Practice published an article and accompanying infographic  that examine the impact pharmacy benefit managers (PBMs) have on cancer care delivery. The article is part of the American Society of Clinical Oncology’s (ASCO) State of Cancer Care in America series, which explores challenges and opportunities in today’s oncology delivery system.