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.
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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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.
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) recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the FY 2021 Hospital Inpatient Prospective Payment System proposed rule.
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 Association for Clinical Oncology (ASCO) submitted comments to the Department of Defense (DoD) in response to the TRICARE Coverage and Payment for Certain Services in Response to the COVID–19 Pandemic interim final rule. The rule allows TRICARE to reimburse providers for audio-only services during the COVID-19 Public Health Emergency (PHE).
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.
In an open letter, the Regulatory Relief Coalition (RRC) called on all health plans in the United States to suspend prior authorization requirements for both COVID-19 and non-COVID-19-related services during the novel coronavirus pandemic.
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.
On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Hospital Inpatient Prospective Payment System (IPPS) proposed rule for 2021. Of particular note, CMS is proposing a new Medicare Severity-Diagnosis Related Group (MS-DRG) for chimeric antigen receptor T-cell therapy (CAR T-cell therapy).
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).
On April 22, HHS announced the allocation of an additional $40.4 billion from the Public Health and Social Services Emergency Fund.
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.
The Department of Health and Human Services (HHS) announced that COVID-19 relief payments to hospitals, physicians, and other health care providers will begin arriving via direct deposit on April 10, 2020—to eligible providers throughout the U.S. health care system.