In letters to the Centers for Medicare & Medicaid Services, the Association for Clinical Oncology commented on provisions that impact cancer care for Medicare beneficiaries in the 2024 Medicare Physician Fee Schedule and Quality Payment Program proposed rule, as well as in the 2024 Hospital Outpatient Prospective Payment System proposal.
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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September 12, 2023
August 15, 2023
The American Society of Clinical Oncology (ASCO) released a detailed analysis of the Centers for Medicare & Medicaid Services' Medicare Physician Fee Schedule proposed rule for 2024. ASCO's analysis looks at how specialty, location, and other factors would impact physician reimbursement under the proposal.
August 3, 2023
On August 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long‑Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. In addition to updating Medicare payment rates and policies for inpatient hospitals in FY 2024, the rule aims to advance health equity and support underserved communities.
July 13, 2023
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2024 Medicare Physician Fee Schedule (PFS) and updates to the Quality Payment Program (QPP). The agency also released the 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule.
July 7, 2023
On July 7, 2023, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule to reimburse hospitals that were underpaid under the 340B drug pricing program since 2018.
April 25, 2023
The Association for Clinical Oncology, and nearly 120 other national physician specialty societies and state medical associations, commend a bipartisan group of physician members of Congress who recently introduced the Strengthening Medicare for Patients and Providers Act (H.R. 2474) in the U.S. House of Representatives. The bill would allow Medicare physicians to receive inflationary reimbursement updates, based on the Medicare Economic Index, similar to those other health care providers receive.
April 25, 2023
The Centers for Medicare & Medicaid Services (CMS) will continue to allow clinicians, groups, and virtual groups in the Merit-based Incentive Payment System (MIPS) use the Extreme and Uncontrollable Circumstances exemption application to request reweighting of one or more MIPS performance categories for the 2023 performance year due to the COVID-19 public health emergency (PHE). CMS expects to release the application in spring 2023. MIPS participants wishing to have one or more performance categories reweighted in the 2023 performance year due to the COVID-19 PHE must complete an application.
April 11, 2023
The Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long‑Term Care Hospital (LTCH) Prospective Payment System (PPS) proposed rule. In addition to updating Medicare payment rates and policies for inpatient hospitals in FY 2024, the proposed rule aims to advance health equity and support underserved communities.
April 11, 2023
The Centers for Medicare & Medicaid Services (CMS) released the 2024 Medicare Advantage and Part D Final Rule, which will revise regulations governing Medicare Advantage (MA), the Medicare Prescription Drug Benefit (Part D), Medicare cost plans, and Programs of All-Inclusive Care for the Elderly (PACE). The rule makes changes related to prior authorization, health equity, marketing and communications, and other areas on which Association for Clinical Oncology (ASCO) commented during the rulemaking process.
April 11, 2023
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.
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 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
Both chambers of the United States Congress are working on a top health care priority for the session—protecting patients from high out-of-pocket drug costs and pharmacy benefit manager (PBM) practices that could reduce access and adherence to treatments. The Association for Clinical Oncology (ASCO) will monitor the status of these bills and any future bills that address PBM practices and patient out-of-pocket costs, and it will work with Congress to ensure the oncology community is heard throughout the process.
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.
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