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

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

Inside Health Policy Reports: CMS to Repay Hospitals for 2019 Site-Neutral Pay Cut

On Dec. 11, 2019, Inside Health Policy reported that the Centers for Medicare & Medicaid Services (CMS) "plans to repay hospitals that sued over 2019 pay cuts from the agency’s so-called site-neutral policy. The agency has also updated the 2019 pay rates for clinic visits at certain off-campus hospital facilities to remove the cut in light of a federal court decision that said the agency didn’t have the authority to implement it."

In September 2019, a Federal Washington, D.C., District Court judge found that CMS exceeded its authority in introducing these cuts in the 2019 Hospital Outpatient Prospective Payment System (HOPPS) rule. Several stakeholder organizations filed suit against CMS in response to the final 2019 (HOPPS) rule's provision that established a new reimbursement rate for off-campus hospital outpatient department clinic visits that aligned the payment rate with that under Medicare's Physician Fee Schedule. The 2019 HOPPS rule extended these payment cuts to providers that were specifically exempted from these site-neutrality reimbursement reductions by the Bipartisan Budget Act of 2015.

Inside Health Policy reports that the "American Hospital Association, Association of American Medical Colleges and others that sued CMS over the cuts say in a Dec. 9 court notice that some hospitals 'recently received payments for claims processed over the past few weeks at the pre-2019 OPPS Rule payment rates for challenged services.' "

Inside Health Policy further reports that: "the [court] notice says that hospitals haven’t been reimbursed for claims from previous months in 2019 and the government has not 'receded from its stated intention to continue to implement in 2020 the same plan this court already vacated.' "

CMS told Inside Health Policy that it began paying hospitals the higher reimbursement rate as of Nov. 4, and that Medicare Administrative Contractors will reprocess claims previously subject to the cut during the first few months of 2019.

ACCC's policy team will provide more information when it becomes available.

Posted 12/12/2019

National Policy Resources—Local Advocacy Results

State Advocacy

Federal Advocacy

FROM THE ACCCBUZZ BLOG

Advocacy In the News

Inside Health Policy Reports: CMS to Repay Hospitals for 2019 Site-Neutral Pay Cut

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