Health Policy Updates

Court sides with patient groups; copay accumulators now limited to branded drugs with generic equivalents.

HHS Names First Ten Drugs for Medicare Negotiations

The Network recently sent a support letter to congressional members on mitigating payment cuts to radiation oncology

Dr. Ralph Heaven of Texas Oncology Abilene publishes op-ed in Dallas Morning News on need for site neutral payments in Cancer Care.

On July 13, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for the 2024 Medicare Physician Fee Schedule (PFS) and Quality Payment Program (QPP).

The bill, introduced by Reps. Jodey Arrington (TX-19), Debbie Lesko (AZ-08), and Michael Burgess, M.D. (TX-26), would establish a more equitable reimbursement structure for cancer care delivered in the community setting.

TX HB 1647 now goes to the Governor’s Desk for signature. WOODLANDS, Texas, May 17, 2023 —The US Oncology Network today commends Texas lawmakers for passing HB 1647 to prohibit pharmacy benefit managers (PBM) or insurers from requiring patients with life-threatening conditions to receive their clinician-administered drugs from a PBM mail-order specialty pharmacy. Prior to…

CMS issued the Medicare Advantage and Part D Final Rule for Contract Year 2024.

The Negotiation program was created by the Inflation Reduction Act and authorizes CMS to negotiate Maximum Fair Prices for certain high expenditure, single source drugs and biological products.

On March 7, the White House released a fact sheet previewing proposals in the President’s forthcoming FY2024 budget aimed at extending the solvency of the Medicare program.