Health Policy Report – April 15, 2025

CCCN Holds Day at the Capitol

On April 2, Comprehensive Cancer Centers of Nevada (CCCN) held its Day at the Capitol in Carson City, Nevada. Throughout the day, CCCN physicians, providers, patients, and administrative staff met with more than 20 members of the Nevada Senate and General Assembly, as well as Governor Joe Lombardo’s health care policy advisor.

The team engaged in productive conversations to educate lawmakers on the critical role community oncology plays in delivering high-quality, accessible, and cost-effective cancer care—particularly for patients in the Las Vegas area. In addition to highlighting the value of community-based care, CCCN representatives advocated for several key healthcare priorities, including expanding screening, ensuring licensure for genetic counselors, limiting PBMs’ abusive practices, and streamlining the prior authorization process.

By engaging with lawmakers and advocating for a strong and accessible healthcare system, CCCN continues to be a leader in providing high-quality community cancer care to Nevadans. Thank you to the physicians, patients, and leaders who traveled to Carson City and helped make our Day at the Nevada Capitol a success! If you are interested in hosting a site visit for your state representative or state senator, please contact Angela.Storseth@usoncology.com.

Dr. Debra Patt Testifies in House Ways and Means Committee Hearing on Biosimilars in Patient Care

On April 8, Dr. Debra Patt, breast cancer specialist, leader of Texas Oncology, and the current President of the Community Oncology Alliance (COA), testified before the House Ways & Means Committee’s Health Subcommittee on the importance of biosimilars in cancer care. 

In her testimony, Dr. Patt discussed how PBMs and the 340B program distort the biosimilar market. 

“PBMs and their related insurers often force physicians not to use the most effective and affordable drugs for our patients, but the most profitable drugs for those corporations,” she stated. Dr. Patt described that this incentivizes the use of more expensive biologics or “private label” biosimilars rather than lower cost biosimilars.

Dr. Patt went on to highlight that the 340B program similarly incentivizes the use of more expensive drugs, as hospitals can purchase them at a significant discount. To foster a more favorable environment, Dr. Patt urges lawmakers to disallow PBM rebates on biosimilars and 340B discounts on originator biologics. Further, she urged lawmakers to increase reimbursement for biosimilars and collaborate with providers to increase awareness of the benefits of biosimilar drugs. 

“Addressing these factors can help ensure that cancer patients have access to a broader range

of effective, more affordable treatment options, ultimately leading to improved health

outcomes and reduced health care costs,” she concluded. 

To read her testimony, CLICK HERE. 

To watch her testimony, CLICK HERE. 

H.R. 2484, the Seniors’ Access to Critical Medications Act to be Marked Up by Energy & Commerce Committee

The bipartisan Seniors’ Access to Critical Medications Act was introduced in the House of Representatives by Reps. Diana Harshbargar (R-TN) and Debbie Wasserman Schultz (D-FL) which would allow patients to access critical medications via mail, courier or caregiver pickup.

The bill, which would protect physicians’ ability to mail drugs directly to their patients, was included in an April 8 markup by the committee. However, the markup ended early due to a House vote and the bill is now scheduled to be marked up on Tuesday, April 29.

H.R. 2484, the Seniors’ Access to Critical Medications Act, would significantly enhance access to essential medications for seniors with cancer and other serious illnesses. This bill would streamline reliable and affordable access to the medications for those – including patients in rural areas – who have difficulty accessing healthcare specialists or pharmacies.

In advance of the markup, on behalf of The Network, Dr. Debra Patt of Texas Oncology submitted a letter to lawmakers urging them to advance the legislation. “Passing H.R. 2484 and allowing independent oncologists and oncology practices to mail or deliver oral prescription cancer drugs to Medicare patients will help protect patients’ access to independent cancer care nationwide,” she wrote.

To read Congresswoman Miller’s statement on the bill, CLICK HER,E.

To read Dr. Patt’s letter on the bill, CLICK HERE.

To read more, CLICK HERE.

Dr. Mehmet Oz Confirmed as CMS Administrator

In a 53-45 party-line vote, the Senate confirmed Mehmet Oz, MD, to serve as the new administrator of the Center for Medicare & Medicaid Services (CMS). In response, Republicans applauded Dr. Oz’s background and commitment to tackling issues such as prior authorization and upcoding, while Democrats voiced concern about Oz’s support to expand Medicare Advantage.

Dr. Oz enters the agency during a time of upheaval, as the Department of Health and Human Services (HHS), which CMS falls under, is currently undergoing a major restructure. Meanwhile, Congress is weighing cuts to the Medicaid program in its reconciliation package.

In any case, Dr. Oz is expected to focus on tackling chronic illness, reducing costs, and improving patient outcomes.

To read more about the confirmation, CLICK HERE.

CMS Issues Medicare Advantage Rules

CMS officially released its CY 2026 finalized payment policies for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs. Following confirmation of Dr. Oz as CMS Administrator, the agency boosted benchmark payment rates for Medicare Advantage plans by an increase of 2.83% from the 2.23% annual increase announced by the Biden administration in January, to 5.06%.

Along with boosting payment rates, CMS announced its commitment to help “protect beneficiaries and taxpayers from waste, fraud, and abuse, while also driving access to high-quality, affordable healthcare through Medicare Advantage.” The payment policies also include completing a three-year phase-in of improvements to the MA risk adjustment model that the agency finalized in the CY 2024 Rate Announcement.

Despite CMS’ aim to ensure Medicare Advantage and Part D plans best meet the needs of enrollees, the program is failing to cut radiation oncology costs, according to new research. Oncologists have expressed MA plan’s limits of networks, increases in prior authorization, and rising out-of-pocket expenses.

To read CMS’ announcement about MA rules, CLICK HERE.

To read more about MA failing to cut radiation therapy costs, CLICK HERE.

Policy Experts Consider What New Tariffs Mean for Healthcare

As the Trump administration continues to consider tariff negotiations, provider groups and health systems are pushing back, calling for exemptions on items like pharmaceuticals and medical devices.

While pharmaceuticals were originally exempted from sweeping tariffs, experts warned that elevated costs along the supply chain could still drive up costs. Meanwhile, healthcare leaders are arguing that any tariffs will impact a broad array of materials necessary for healthcare delivery, including syringes, diagnostic tools, equipment, such as X-ray machines and personal protective equipment.

In a letter led by House Representatives Doris Matsui (D-CA) and Brad Schneider (D-IL), House Democrats warned Howard Lutnick, Secretary of Commerce, that tariffs would endanger medical supply chains. “The supply disruptions of critical medical products will unavoidably hurt U.S. patients, force providers to make impossible rationing decisions, and potentially even result in death as treatments are delayed, or more effective medicines and products are swapped for less effective alternatives,” the lawmakers wrote.

In response to the Trump administration’s 90-day pause on most tariffs, advocacy groups applauded and urged President Trump to grant long-term exemptions for medical products.

To read more, CLICK HERE.