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Access, Payment & Reimbursement Reform

ACCC is committed to ensuring that cancer patients have access to the entire continuum of quality cancer care, including access to the most appropriate cancer therapies.

  • CMS Delays Radiation Oncology Model For Further Rulemaking

    On August 29, 2022, the Centers for Medicare & Medicaid Services (CMS) published a final rule (CMS-5527-F2) that finalized delaying the Radiation Oncology Model start date until a date is determined through future rulemaking.

    For more information, visit the Radiation Oncology Model website.

    Posted 8/30/2022



  • CMS Innovation Center Announces EOM Informational Webinar

    With the Centers for Medicare & Medicaid Services' (CMS') announcement about the Enhancing Oncology Model (EOM), it has released registration for an informational webinar on the model.

    The EOM is designed to test how to best place patients with cancer at the center of their care team, who is providing high-value, equitable, and evidence-based care. It aims to improve care coordination, quality, and health outcomes for patients, while also holding oncology practices and programs accountable for total costs of care to make cancer care more affordable and accessible for Medicare and its beneficiaries.

    This webinar will offer further information on the EOM, as an alternative payment model, and will feature a Q&A segment to answer your questions. The webinar will take place Thursday, June 30, from 3:00 to 4:30 PM EDT. You can register online.

    Visit the CMS website for additional information about the EOM and to view applications. 

    Posted 6/29/2022



  • CMS Announces the Enhancing Oncology Model

    On June 27, 2022, the Biden Administration, through the Department of Health and Human Services and Centers for Medicare & Medicaid Services (CMS), announced a new model to improve cancer care for Medicare patients: the Enhancing Oncology Model (EOM). This model is the successor to the Oncology Care Model (OCM).

    The EOM—designed by the Center for Medicare and Medicaid Innovation—will tackle the health inequities and meet patients' throughout the cancer care continuum, with an emphasis on person-centered care and better patient outcomes. The model will run from July 2023 through June 2028, and its participants will include oncology practices that treat people with Medicare undergoing chemotherapy for breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer. 

    For additional information regarding the EOM, visit the CMS website. Then read ACCC's statement.

    Posted 6/29/2022



CMS CY 2023 Physician Fee Schedule Proposed Rule

On July 7, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) proposed rule, which would significantly expand access to Medicare telehealth services, colorectal cancer screening, and medically necessary dental service. The rule also proposes several changes to reimbursement and the Quality Payment Program (QPP) that are relevant to oncology care providers. ACCC submitted formal comments in response to the proposed rule on September 6.
Read the Letter

CMS CY 2023 Hospital Outpatient Prospective Payment System Proposed Rule

On July 15, CMS issued the (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) proposed rule, which proposes changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS. The agency also proposes to update reimbursement for 340B-acquired drugs following the recent Supreme Court decision in American Hospital Association v. Becerra. ACCC submitted formal comments in response to the proposed rule on September 13.
Read the Letter

 

Archived Documents

Archive of ACCC Comment Letters on CMS Physician Fee Schedule:

Archive of ACCC Comment Letters to CMS on Recent OPPS Proposed Rules: