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May 2022 Issue

MDCSCO Insights

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2022 Highlights of ASH in North America

Don’t miss the ONLY official event that provides synopses of the top hematology research presented at the 63rd ASH Annual Meeting and Exposition this past December. The all virtual experience this year will take place between March 16 and April 9, 2022. Registration for the Highlights of ASH in North America includes 15 prerecorded presentations, five live Q&A sessions, and complimentary access to the Highlights of ASH International program. Discuss rapidly evolving developments in hematology with leading faculty in the field; discover new treatments for patients; and improve your overall practice methods.

In addition to viewing curated annual meeting content, participants will also be able to network with industry partners through virtual exhibits and the virtual Satellite Symposia. CME, MOC, and/or Certificates of Attendance are available after watching select live and recorded sessions.

CALL TO ACTION: Clinical Treatment Act Implementation

Beginning on January 1, 2022, all states and territories will be required to cover and reimburse for the routine costs of care for services associated with Medicaid enrollee participation in a qualifying clinical trial. The Center for Medicaid and CHIP Services (CMCS) issued a State Medicaid Director Letter outlining new Medicaid state plan requirements, including what is/is not a covered service, definition of a qualifying clinical trial, coverage determinations, and state exceptions for compliance as presented in the legislation.

CMCS is instructing states to submit a state plan amendment (SPA) describing coverage, benefits, and payment methodology used to pay service providers for routine costs associated with clinical trials in each state. The SPA should be issued at least one day prior to the effective date of the proposed changes. To ensure equitable, transparent, consistent, and comprehensive coverage requirements across all states, ASCO drafted a SPA offering specific and technical coverage and reimbursement recommendations. The SPA is intended to serve as a model submission from state Medicaid agencies to CMCS. We have also attached an accompanying "challenges" document which provides the rationale for the provisions included in the SPA and other implementation considerations.

We urge State Affiliates to send the attached SPA and challenges document to your State Medicaid Agency requesting they consider our recommendations as they draft their own. With the CLINICAL TREATMENT Act effective in less than two weeks, we recommend sending this as soon as possible. Please contact Gina Hoxie at [email protected] with any questions or for additional information.

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