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.

State Advocacy

House Unanimously Votes to Curb Non-Medical Switching of Prescriptions

The Iowa House has unanimously voted to set new rules to prevent prescription drug switches that are not done for medical reasons. Representative Gary Mohr of Bettendorf said this is to protect patients from being denied coverage or being required to accept higher co-pays in the middle of a health plan’s year.

Do you have a patient that has experienced this challenge? We would like to speak with you and/or the patient. Our goal is to share as many of these stories with Iowa legislators as we can. We can help put the message together and, if you’re interested, set up a meeting with your legislator. To participate, please contact Lu Anne Bankert at lbankert@accc-cancer.org by Thursday, March 23, 2023.

Federal Advocacy

IOS Joins Coalition Letter Urging Addition of the Cures 2.0 Concept Paper Title IV Provisions in the Next COVID-19 Relief Package

The Iowa Oncology Society (IOS) joined in a coalition letter to congressional leadership urging that Congress include the 21st Century Cures 2.0 concept paper, recently released by Representatives Diana DeGette and Fred Upton in upcoming legislation to further address the COVID-19 public health crisis. Specifically the letter urges leadership to include policy to provide Medicaid coverage of the routine care costs of clinical trials participation for patients with life-threatening conditions in every state. This critical protection is championed by Representatives Ben Ray Luján and Gus Bilirakis in the Clinical Treatment Act (H.R. 913).

COVID-19 Clinical Trials Coalition 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

AONN+ Leadership Council Shares Need for Complete Cancer Care Team

On March 30, 2021, the Academy of Oncology Nurse & Patient Navigators (AONN+) Leadership Council released key reasons why cancer care teams should be protected and thoughtful investment strategies for cancer programs and practices to help remain strong as they recover from the pandemic. After closely reviewing the pandemic's impact on cancer care delivery in 2020, the Leadership Council devised key reasoning for protecting the cancer care team and service line:

Newly diagnosed patient volumes will increase along with diagnoses of advanced disease
Cancer service line revenues will be impacted if care organization is not streamlined and efficient
The navigation team (e.g., navigators, social workers, etc.) will be difficult to reassemble
Navigation can address cancer disparities.

"With new testing and mitigation strategies being implemented and improved access to vaccines on the horizon, now is the time to proactively plan for the near future. With proper and realistic planning, members of the cancer care team can be well-positioned to serve their patients with cancer and their families as the pandemic begins to subside."

The AONN+ Leadership Council is led by Christian Downs, executive director of the Association of Community Cancer Centers, with support from Linda Fleisher, principal investigator at Fox Chase Cancer Center, Lillie Shockney, co-founder of AONN+, Rani Khetarpal, vice president of Provider Partnerships at New Century Health, and Mandi Pratt-Chapman, associate center director of Patient-Centered Initiatives and Health Equity at George Washington Cancer Center.

For more information on the Leadership Councils' tips for a strong cancer care team post-pandemic, read the full announcement.

Posted 4/7/2021