Legislative Action Center
Together we can help key policy makers at the federal and local levels better understand how their decisions on policy and legislation impact community oncology care. State and federal legislation can have a real impact on your bottom line, and ultimately how you deliver care, which is why it's so important that ACCC members bring their on-the-frontline perspectives to the legislative process.
Call to Action: Support Permanent Repeal of the SGR
On March 26, by a vote of 392-37 the U.S. House of Representatives overwhelmingly passed H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA), to permanently replace Medicare’s Sustainable Growth Rate (SGR). Read a summary of the legislation here.
Unfortunately, the U.S. Senate recessed on Friday, March 27, without voting on the SGR repeal legislation.
The Senate is recessed for two weeks, but is expected to act on the permanent SGR repeal bill when it reconvenes on April 13.
H.R. 2 would create an improved physician payment system that rewards quality, efficiency, and innovation and put an end to the cycle of annual “doc fix” crises that have created uncertainty for millions of Medicare providers and beneficiaries for over a decade. As you well know, physicians need the assurance of predictable, appropriate payments in order to plan for the future and invest in the personnel and technologies that are essential to providing high-qualitycancer care.
This is historic momentum on an issue that has plagued providers—and Congress— for years. This year’s compromise builds on last year’s efforts, and the window to get this bill across the finish line is narrowing. Join us in urging the Senate to pass responsible legislation that appropriately reimburses patient care.
Contact your Senators and ask them to support a permanent repeal of the SGR. As an expert in cancer care, they need to hear from you!
The Cancer Policy Landscape
ACCC's 2015 Capitol Hill Day on March 16 focused on the following issues that are critical to preserving quality cancer care:
- Sustainable Growth Rate: End the short-term patches and permanently replace the SGR with responsible policy that emphasizes value over volume.
Because the formula that determines Medicare reimbursement is fundamentally flawed, Congress is forced to step in each year to avoid enormous cuts to providers. The Congressional Budget Office (CBO) has scored a permanent repeal of the SGR at $144 billion over 10 years. This is lower than previous estimates, making this the right time to permanently fix the SGR.
- Oral Parity: Pass oral parity reform and require health insurance plans to cover orally administered chemotherapy at the same rate as IV-infused counterparts.
Oral chemotherapy may provide an easier, less intrusive way to fight various types of cancer, but unless Congress acts to create reimbursement equity between oral and IV-infused treatments, most patients will not be able to afford these oral treatment regimens.
- Prompt Pay Discount: Support H.R. 696, a bill that excludes the prompt pay discount from Medicare’s reimbursement calculation, restoring reimbursement to congressionally intended levels.
Because of the way Medicare is reimbursed using average sales price (ASP), the discount that is customarily provided to drug distributors by manufacturers when they pay promptly for drugs (Prompt Pay Discount) is not passed on to the providers who buy the drugs to give directly to their patients. Result: providers miss about 2 percent of the intended reimbursement on all drugs. This is in addition to other cuts to Medicare reimbursement that providers face, like the sequester. Failure to exclude prompt pay discounts from the calculation of ASP threatens the current distribution model for specialty products and artificially lowers Part B reimbursement for physicians and other providers.