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!

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

CMS Releases CY 2019 OPPS Rule

On November 2, the Centers for Medicare & Medicaid Services (CMS) released the final calendar year (CY) 2019 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule.

Download the final 2019 OPPS rule from the Federal Register here.

Highlights from the CMS fact sheet on the final rule include:

CMS is exercising its authority by applying a Physician Fee Schedule (PFS)-equivalent payment rate for the clinic visit service when provided at an off-campus provider-based department that is paid under the OPPS. The agency will phase this change in over two years.
In the 2019 OPPS final rule, CMS finalizes a policy to pay ASP minus 22.5 percent for 340B-acquired drugs furnished by non-excepted off-campus PBDs paid under the Physician Fee Schedule.
For 2019, CMS is not finalizing its proposed policy that off-campus PBDs excepted from Section 603 of the Bipartisan Budget Act of 2015 could continue to be paid at OPPS rates for items and services in each of 19 proposed “clinical families of services” if a PBD furnished and billed for a service in that clinical family of services prior to November 2, 2015. CMS notes the agency will continue to monitor the expansion of services in excepted off-campus PBDs.

For more information, access the CMS fact sheet on the final CY 2019 OPPS rule here.

ACCC is currently reviewing the final 2019 OPPS rule and will provide an in-depth analysis to membership shortly.