National Policy Resources—Local Advocacy Results

As cancer care professionals who experience the challenges of providing quality cancer care first-hand, IOS members are well positioned to educate decision-makers on how coverage and reimbursement issues affect community oncology. State and federal legislation can have a significant impact on the financial viability of local cancer programs, which is why it's so important that our members make their voices heard.

In an effort to provide resources needed to effectively advocate on the issues that are important to them, our redesigned advocacy webpage features activity from the Centers for Medicare & Medicaid Services (CMS), national healthcare coverage through the Association of Community Cancer Centers (ACCC), local news articles and webinars, and more.

We want to hear from you! If there is a specific piece of legislation you want to know more about, an important resource we're missing, or if you want to get more involved, please contact us!

Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services

As of January 1, 2024, the Centers for Medicare and Medicaid Services introduced new codes so that Medicare could reimburse for patient navigation services. To address challenges of implementation, the Association of Cancer Care Centers, in partnership with TACOS and 11 other state societies from CO, IN, IA, NV, NM, NY, NC, SC, WA, WI, and WY, has a 4-part webinar series, Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services, hosted by Teri Bedard of Revenue Cycle Coding Strategies.

The New CMS Navigation Reimbursement Billing Codes: A 101

The 2024 Physician Fee Schedule included 7 new codes specific to care management. This webinar reviews how these differ from the care management codes available from the American Medical Association, common questions, and challenges for implementing these new codes.
Access a PDF of the slides here.

Principal Illness Navigation (PIN) Services Documentation, Coding, and Billing

The 2024 Physician Fee Schedule includes four new codes specific to Principal Illness Navigation–Peer Support. With these new codes, providers will be able to bill for the services of navigators, social workers, and support personnel. This webinar goes into a deep dive, reviewing components of the new codes, answering common questions, and addressing challenges for providers.
Access a PDF of the slides here.

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ASCO® Advocacy Summit
April 16-17, 2024

Mark A. Henderson, MD, President for Indiana Oncology Society (IOS), Named Advocacy Champion by the Association for Clinical Oncology

The Association for Clinical Oncology (ASCO) named Dr. Henderson as an Advocacy Champion during the 2024 ASCO Advocacy Summit in April. Advocacy Champions are ASCO volunteers who have made meaningful contributions to the Association’s advocacy activities throughout the year to ensure that every patient with cancer has access to high-quality, equitable cancer care no matter who they are or where they live. Advocates speak with federal lawmakers and agencies, send personalized letters to Members of Congress through ASCO’s ACT Network, engage with state lawmakers on policy priorities at the state-level, and host site visits for lawmakers in their home states and districts.

Throughout the past year, Dr. Henderson has worked with IOS on Policy in Indiana that would affect cancer patients along with federal policy.

Mark A. Henderson, MD is a Radiation Oncologists at Columbus Regional Hospital Cancer Care For more news, advocacy, and analysis on cancer policy, please visit asco.org/ascoaction.

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2024 ASCO Advocacy Day

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IOS President, Mark Henderson, MD, ASCO President Elect, Robin Zon, MD, meet with Rep Rudy Yakym III

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IOS President outside the Capital in
Washington, DC

State Advocacy

On July 1, 2021, the Indiana Department of Health, Indiana Board of Pharmacy, Indiana Department of Insurance, and the Indiana Family and Social Services Administration released its Specialty Drug Channel Management Report.

The report identifies the recent effects of white bagging in Indiana and why the practice of white bagging is a safety risk for patients. In addition to state and federal considerations, the report provides examples of patient experiences and outlines best practices for reimbursement and communications.

Stay tuned for more communications and advocacy opportunities from the Indiana Oncology Society as we work with these state organizations to ensure that we provide the best care for patients with cancer across the Hoosier state.

Download Report

Federal Advocacy

IOS Joins 400+ Organizations in Support of MCED Legislation
May 5, 2022

The Indiana Oncology Society (IOS) joined more than 400 organization from all 50 states to urge Congress to pass the Medicare Multi-Cancer Early Detection (MCED) Screening Coverage Act (H.R.1946/S.1873) this year. This legislation would create a pathway for MCED tests to be covered by the Medicare program following approval by the Food and Drug Administration (FDA).

Read the Letter

FROM THE ACCCBUZZ BLOG

An Update on Healthcare Legislation at the State Level
By Christian G. Downs, MHA, JD
March 22, 2023
If you are looking for legislative action, look no further than your state's legislatures. Most—if not all—states have had issues relating to oncology care and healthcare in general come up during their 2023 sessions.
ACCC Announces its 2023 Advocacy Agenda
March 07, 2023
For 2023, ACCC members have identified four core areas of focus (e.g., reimbursement, utilization management, provider-patient choice), among a larger set of issues and concerns, that the association will be supporting this year.
ACCC Recognizes National Caregivers Day: Analyzing a Mental Health Crisis
February 17, 2023
Today is National Caregivers Day, and ACCCBuzz analyzes the current mental health crisis that is affecting the caregivers of loved ones everywhere.

Advocacy In the News

ACCC Comments to CMS on Proposed RO Model

On September 16, the Association of Community Cancer Centers (ACCC) submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the agency's proposed Radiation Oncology (RO) Model rule.

In its comment letter, ACCC expresses committed support for the movement toward value-based care, noting that ACCC members have long been leaders in developing and participating in value-based payment systems.

As CMS looks to finalize a model for radiation oncology, ACCC urges the agency to:

Make significant changes to the proposed episode payment methodology to ensure that the RO Model incentivizes innovation and cost-efficient care while allowing for equitable treatment of model participants.
Phase in mandatory participation in the RO Model to ensure equitable opportunity for success and ensure accurate and useful results from the model.
Delay the start of the RO Model until July 1, 2020 at a minimum.
Finalize the proposed exclusion of radiopharmaceuticals and certain brachytherapy surgical procedures from services covered by bundled payment.
Begin a new RT episode when a new course of treatment begins before a pending 90-day RT episode is complete.
Clarify certain aspects of the proposed quality reporting requirements.
Reconsider the uncompensated burden that would be required to comply with proposed monitoring and peer review requirements, which are not tied to pay for reporting.
Apply the 5 percent Advanced Alternative Payment Model (APM) incentive payment to the technical component of the RO Model payments as well as the professional component.
Structure the final RO Model so that all participants will be qualifying participants in an Advanced APM for purposes of the QPP, assuming minimum participation requirements are met.
Open the RO Model to voluntary participation by the Medicare Advantage plans and other payers.
Clarify how the RO Model will overlap with the Oncology Care Model (OCM) in a manner that allows for full and fair participation in both models.

Read ACCC's comment letter.

Posted 9/23/2019