November 2019

American Cancer Society Announces New Video Series Created to Deliver Clinical and Emotional Support to Cancer Caregivers.

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October 2019

Community Needs More Time to Assess and Comment on CMMI’s Proposed Oncology Care First Model
Recently the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) released an informal request for information for a new model for value-based payments in oncology known as the “Oncology Care First” (OCF) model.  However, oncology practices and stakeholders need more time to adequately assess and provide detailed feedback on the OCF than the time CMMI has allotted.

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United Health and Optum 'Uniting Care and Coverage' in New Model
UnitedHealth Group and its Optum medical care provider business are rolling out a combined package of medical care and health insurance as they meld health benefits with the provision of healthcare services.

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Patients Need Protection From Surprise Medical Bills, Organizations Tell Congress
In a letter to leaders of the U.S. Senate and House of Representatives, ASCO, along with more than 100 other medical groups, urged Congress to protect patients from unanticipated, or “surprise,” medical bills that can occur when gaps in health insurance coverage lead them to receive care from out-of-network providers.

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New Survey Seeks Provider Input on Clinical Trial Enrollment
ASCO is participating in a joint initiative from the American Cancer Society's Cancer Action Network in conjunction with the Association of Community Cancer Centers and the Oncology Nursing Society.  Click below to access the survey.

Click here for the survey

Walmart to Measure Doctor Quality in Local Markets
Walmart is rolling out an effort to measure the quality of community doctors who treat tens of thousands of its employees in the retailer’s latest effort to make sure its workers get the right care, in the right place and at the right time.

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CMS to Collect 340B Drug Cost Information
The CMS issued a notice on September 26th that it will collect information from hospitals participating in the 340B drug discount program about the prices they pay for eligible drugs.

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Educate and Support Your Patients with ASCO Answers Materials

Recently, State Affiliate presidents and executive directors received a mailing from Cancer.Net that included patient education materials that you and your members may find useful. These materials, along with additional resources that can be found on Cancer.Net give your patients ASCO-approved information on diagnosis, treatment, side effects, and psychosocial effects of cancer.  The ASCO Answers series includes fact sheets, booklets on specific topics in cancer care, and comprehensive, patient-friendly guides. These easy-to-read materials cover breast cancer, colorectal cancer, non-small cell lung cancer, small cell lung cancer, prostate cancer, cancer survivorship, caregiving, palliative care, managing cancer-related pain, advanced cancer care planning, and much more.  ASCO members save 20 percent.  All orders include free domestic shipping. 

Order printed copies online at the ASCO Store.

New Technology Add-on Payment: Impact on CAR T-cell Therapy Reimbursement
On August 2, the Centers for Medicare & Medicaid Services (CMS) released the Hospital Inpatient Prospective Payment System (IPPS) final rule for fiscal year (FY) 2020.

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CMS Expands CAR T-cell Therapy Coverage for Medicare Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) announced that Medicare will now cover all Food and Drug Administration-approved Chimeric Antigen Receptor T-cell (CAR T-cell) therapy delivered in inpatient facilities.  This nationwide Medicare coverage increase for CAR T-cell therapy also opens the door for patients to receive treatment in outpatient health care facilities that are enrolled in FDS risk evaluation and mitigation strategies with expertise in delivering cellular therapies, and covers CAR T-cell therapy for off-label uses that are recommended by CMS-approved compendia.

Read more here

 

September 2019

Could Biosimilars Be Integrated into Alternative Payment Models?

Michael Kolodziej, MD, Vice President and Chief Innovation Officer at ADVI Health, Inc, addresses the role that biosimilars will have in alternative payment models in oncology.

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Cancer Pain Predicted by Lower Anxiety and Depression, Higher Social Support
A new study from the Levine Cancer Institute finds that patients with cancer who report higher levels of anxiety and depression experience more intense pain associated with their diseases.

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Nearly 60% of Blood Cancer Patients Covered by Medicare Delay or Forgo Treatment
Survival of older patients with blood cancers continues to improve as more effective, less toxic therapies are introduced. However, these lifesaving treatments often are expensive and many cancer patients face financial burdens caused by ever-increasing healthcare costs. In fact, according to a new study released October 21st by The Leukemia & Lymphoma Society (LLS), 59 percent of surviving blood cancer patients enrolled in traditional Medicare do not begin active treatment within three months of their diagnosis.

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Report: Progress in Global Cancer Fight is Not Only Possible, but Achievable
The Cancer Atlas, 3rd edition, a comprehensive global overview of cancer around the globe, concludes that progress in the fight against cancer is not only possible, but achievable.

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Cancer Drugs Account for 27% of All New Drug Approvals in the US

Cancer drugs currently account for 27% of all new drug approvals in the United States since 2010, a dramatic increase from the 4% share of the 1980s, a newly completed analysis from the Tufts Center for the Study of Drug Development shows.

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Sharing Hospital Outpatient Payment Proposal Maintains 340B Cuts, Addresses Price Transparency and Prior Authorization
On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for reimbursement under the Hospital Outpatient Prospective Payment System (HOPPS) in 2020. ASCO is still analyzing the proposal and will provide more information to members as soon as possible.

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CMS' "Fail First" Step Therapy Policy Means Medicare Patients with Cancer Will Face More Dangerous Delays and Denials
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) codified its decision to allow MA plans to use “fail first” step therapy for new starts of Part B drugs for cancer and other serious diseases. The Trump administration’s decision to finalize step therapy in MA plans means that Medicare patients with cancer will face nightmares of delays and denials while trying to access their physician-prescribed treatments

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Improving Seniors’ Timely Access to Care Act of 2019

Maryland/DC Society of Clinical Oncology is proud to have joined with hundreds of other health organizations to support the Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107) recently introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger Marshall, MD (R-KS), and Ami Bera, MD (D-CA).

Read the letter here.


Janssen provides discussion paper for 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule.

The CMS fact sheet is available here. In the FY 2020 IPPS Proposed Rule, CMS addresses how the agency proposes to pay for CAR T-cell therapy administered on an inpatient basis.

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ASTRO releases updated radiation oncology safety guide
In conjunction with Patient Safety Awareness Week, the American Society for Radiation Oncology (ASTRO) published an update today to its framework for safe and effective radiation therapy treatment. The comprehensive reference guide, Safety is No Accident: A Framework for Quality Radiation Oncology and Care, is available for download.

 

CDC Issues Key Clarification on Guideline for Prescribing Opioids for Chronic Pain
Agency Clarifies CDC Guideline Not Meant to Limit Access to Appropriate Pain Management for Individuals with Cancer, Sickle Cell Disease

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CMS Proposes New Electronic Prior Authorization Process to Speed Access to Care
CMS recently issued a proposed rule to update and streamline the prior authorization process under Medicare Part D.

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Economic Cost of Cancer in U.S. Tops $94B Annually According to a Study

State-by-state variations in cancer deaths suggest that effective cancer prevention and treatment could yield economic benefits, according to a study published in JAMA Oncology.

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