On January 1, a provision of the Inflation Reduction Act (IRA) went into effect requiring drug companies to pay rebates to Medicare when prescription drug prices increase faster than the rate of inflation for certain drugs given to people enrolled in the program. The provision also provides for lower Medicare Part B beneficiary cost sharing on such drugs beginning April 1, 2023.
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.
To sign up for advocacy alerts, log in to ASCO.org with your member or guest account, and visit the subscription center available under your account profile.
March 20, 2023
March 14, 2023
The Association for Clinical Oncology (ASCO) submitted comments in response to a Centers for Medicare & Medicaid Services' (CMS) proposal is to streamline prior authorization by requiring Medicare Advantage plans, Medicaid plans, and Qualified Health Plans (QHP) on Federally Facilitated Exchanges (FFEs) to establish an electronic prior authorization process that would be integrated into a provider’s workflow.
February 28, 2023
On January 30, the Biden Administration announced the COVID-19 Public Health Emergency (PHE) will end on May 11, 2023. The PHE enabled flexibilities that helped providers treat patients during the pandemic. With the PHE ending, many of these flexibilities are being phased out. The American Society of Clinical Oncology (ASCO) summarized the known end dates of some major flexibilities of interest to oncologists.
February 16, 2023
On February 14, 2023, the Centers for Medicare & Medicaid Services (CMS) announced that the Secretary of the Department of Health and Human Services (HHS) selected three models aiming to address high prescription drug costs for testing by the Center for Medicare and Medicaid Innovation (CMMI). This effort to identify ways to lower drug costs in United States comes in response to President Biden’s Executive Order, “Lowering Prescription Drug Costs for Americans,” which complements provisions in the Inflation Reduction Act (IRA).
February 14, 2023
The American Medical Association (AMA) released an updated Specialty Impact Table for Medicare physician reimbursement in calendar year 2023. The estimated impact on the hematology/oncology specialty is now -1% for 2023. Though, individual or practice level effects of these changes will vary based on geographic location, service location, and mix of services billed.
February 14, 2023
The Association for Clinical Oncology (ASCO) submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) Contract Year 2024 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Programs proposed rule. ASCO’s comments focus heavily on the proposed changes to prior authorization in the MA program in addition to enhancing health equity and other updates to the Part D drug benefit program.
January 31, 2023
The Association for Clinical Oncology (ASCO) submitted comments in response to the Centers for Medicare & Medicaid Services’ (CMS) Patient Protection and Affordable Care Act 2024 Notice of Benefit and Payment Parameters proposed rule. ASCO’s comments support proposals aimed at reducing or eliminating gaps in health care coverage, and the Association continues to advocate for beneficiary protections by opposing the use of copay accumulator programs.
January 31, 2023
On January 30, 2023, President Biden announced the COVID-19 Public Health Emergency (PHE) will end on May 11, 2023. This announcement comes after the Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the PHE earlier in January.