Health Policy Report – April 21, 2026

Comprehensive Cancer Centers of Nevada (CCCN) Meets with Senator Cortez Masto
On Friday, April 10, The US Oncology Network, alongside Comprehensive Cancer Centers of Nevada (CCCN), met with Senator Catherine Cortez Masto (D-NV) in Las Vegas, Nevada to discuss H.R. 4299, the Protecting Patient Access to Cancer and Complex Therapies Act.

The discussion focused on the local impact of Medicare Part B drug reimbursement changes under the Inflation Reduction Act (IRA), particularly how current policy could affect the ability of community oncology practices to continue providing high quality, accessible cancer care in southern Nevada.

Physicians, practice leadership, and a patient representative shared firsthand perspectives about how destabilizing reimbursement cuts could restrict patient access and shift care into higher cost hospital settings. Throughout the meeting, Senator Cortez Masto demonstrated strong engagement with both the policy and the practical mechanics of the legislation, asking thoughtful and detailed questions about how H.R. 4299 would operate, how it aligns with the intent of the IRA, and how Congress can effectively advance the bill.

Senator Cortez Masto reaffirmed her commitment to ensuring that community oncology remains a viable and essential part of the cancer care delivery system in Nevada. CCCN and The Network look forward to working more closely with Senator Cortez Masto on this important legislation.

The US Oncology Network Publishes 2026 Capitol Report
The Network is pleased to announce the publication of the 2026 Capitol Report, now live on LegisLink.com. The Capitol Report highlights The Network’s advocacy on behalf of community oncology, highlighting key policy wins over the last year. 

“Thanks to the strong voice of independent community oncologists, The Network has been at the forefront of long-standing efforts to advance meaningful site neutral payment reform, take action to rein in pharmacy benefit managers, expand access to cancer screening, and secure sustainable physician payment reform. Over the past year, we’ve achieved meaningful progress on each of these priorities – proof that our ongoing advocacy is delivering real results for community oncology,” said Ben Jones, Senior Vice President, Government Relations & Marketing, at The US Oncology Network.

The Capitol Report recognizes physicians and practice staff who have participated in our annual fly-in, Days at the Capitol, site visits, and other advocacy events. If you are interested in hosting a site visit, please contact Angela.Storseth@usoncology.com.

To read the 2026 Capitol Report, CLICK HERE.

Texas Oncology Organizes West Texas Permian Basin Summit

Texas Oncology recently partnered with Genentech to organize the West Texas Permian Basin Summit. The event brought together over 100 local advocates and healthcare leaders to discuss the need to improve patient access to care in rural communities. The summit marks the beginning of an initiative focusing on how to improve healthcare infrastructure in West Texas. 

Dr. Steve Paulson, President and CEO of Texas Oncology, stressed the need for collective action to achieve this goal. “I think the most important word to take away from today is ‘we.’ It’s amazing what can be accomplished if you don’t care who gets credit. In this situation, we all can feel good about bringing services to the community that are not present today,” Paulson said.

To read more, CLICK HERE.

Drs. Gordan and Patt Participate in Panel on AI in Cancer Care

On April 17, Dr. Lucio Gordan, President and Managing Physician of Florida Cancer Specialists & Research Institute, and Dr. Debra Patt, Executive Vice President of Texas Oncology, participated in a panel discussion titled, “Al in Oncology: Tools for Today, Breaking and Remaking For Tomorrow” at the Association of Cancer Care Centers (ACCC) Leadership Summit in Washington, D.C.

During the panel, Drs. Gordan and Patt highlighted how AI tools are rapidly transforming cancer care and what these trends mean for physicians. They shared their perspective on how AI can support operations, care delivery, and patient engagement.

Senate HELP Committee Holds Hearing on Drug Pricing
On April 16, the Senate Committee on Health, Education, Labor & Pensions (HELP) convened a hearing focused on drug pricing. The hearing featured three witnesses – Brian J. Miller, MD, MPH, MBA, of The Johns Hopkins University School of Medicine and the Hoover Institution, Robert Weissman, J.D. of Public Citizen, and Ryan Long, J.D of Paragon Health Institute, a conservative think tank.

The hearing covered a broad range of drug pricing topics, including the need to address perverse incentives in the 340B Drug Pricing Program and remove barriers to accessing biosimilars.

The hearing came as the Trump administration urges Republicans to codify the voluntary deals that drugmakers have struck to achieve most-favored-nation (MFN) drug pricing. Ahead of the hearing, Senate Democrats released a report, which found companies that signed drug pricing deals with President Trump have raised the cost of hundreds of medications and launched new ones at an average price of $353,000 a year.

To watch the hearing, CLICK HERE.

To read more about the report, CLICK HERE.

AbbVie Lawsuit Aims to Narrow Patient Definition Under 340B Drug Pricing Program
AbbVie recently filed a lawsuit challenging the criteria that qualify patients for drug discounts under the 340B Drug Pricing Program.

In a complaint against the Department of Health and Human Services (HHS) and the Health Resources and Services Administration (HRSA), AbbVie argued that a clearer definition of who is a patient would “restore integrity” in the 340B program. The lawsuit comes as drugmakers are pushing for reform of the 340B program, which is meant to help hospitals and clinics serve low-income populations. The program has come under recent scrutiny, however, with multiple analyses showing that drug discounts are not passed on to patients.  

“Our filing seeks to establish a clear, sensible patient definition to realign 340B with its original intent—serving vulnerable individuals and true safety net providers, not padding revenue streams that increase overall healthcare costs,” AbbVie said in a statement. 

To read AbbVie’s statement, CLICK HERE.

To read more about the lawsuit, CLICK HERE.

CMS Releases “Interoperability Standards and Prior Authorization for Drugs” Proposed Rule, As Insurers Claim Reductions in Prior Authorization

On April 10, CMS released a proposed rule, titled “Interoperability Standards and Prior Authorization for Drugs,” which would streamline prior authorization requirements for prescription drugs, with the goal of improving patient access to care, reducing administrative burden, and increasing transparency.

This proposal builds on CMS’ 2024 Interoperability and Prior Authorization Final Rule. The electronic prior authorization and decision-timeframe requirements would apply to Medicare Advantage (MA) plans; Medicaid, Children’s Health Insurance Plans (CHIP), and Qualified Health Plans (QHPs) offered on the federally-facilitated exchanges; and small group market plans on the Federally facilitated SHOP (FF-SHOP). If finalized as proposed, the rule would have meaningful implications for community oncology practices.

Meanwhile, America’s Health Insurance Plans (AHIP) and Blue Cross Blue Shield recently released a study showing that insurers’ pledge to streamline prior authorization requirements has led to 6.5 million fewer prior authorizations and a 15% decrease in Medicare Advantage (MA) claim reviews. The study showed that prior authorizations overall had decreased by 11% so far in 2026 compared with two years ago. While many groups welcomed the news, patient advocacy groups are continuing their push for Congress and the Centers for Medicare & Medicaid Services (CMS) to curb prior authorization through new laws and regulations.

To read a fact sheet about the proposed interoperability rule, CLICK HERE.

To read more the study released by AHIP and Blue Cross Blue Shield, CLICK HERE.

CMS Proposes Pay Increase for Inpatient Hospital Services

On April 10, the Centers for Medicare & Medicaid Services (CMS) released its Inpatient Prospective Payment System (IPPS) rule for 2027, which proposes a 2.4% payment bump for inpatient hospital services.

This bump reflects a 3.2% market basket increase and -0.8% productivity adjustment. CMS expects the proposed changes to increase hospital payments by about $1.4 billion, and additional payments for inpatient cases involving new medical technologies will increase by about $464 million in the coming fiscal year.

In response, the American Hospital Association (AHA) argued that the proposed increase is insufficient to make up for sweeping Medicaid cuts. Ashley Thompson, senior vice president of public policy analysis and development at AHA, said the increase is “another inadequate update to inpatient payment rates, another extremely high productivity cut, and reductions to disproportionate share payments.”

To read a fact sheet about the rule, CLICK HERE.

To read more about the issue, CLICK HERE.

HHS Secretary RFK Jr. Testifies on HHS Budget Before Congress
On April 16, Robert F. Kennedy, Jr., Secretary of the Department of Health & Human Services (HHS), testified before the House Committees on Ways & Means and Appropriations to discuss HHS’ budget.

During the House Ways & Means Committee hearing, Kennedy touted the agency’s accomplishments on a range of issues, including Medicare drug price negotiations, chronic disease, and rural healthcare. Republican lawmakers focused their questioning on reining in pharmacy benefit managers (PBMs) and prior authorization, as well as addressing fraud and abuse in Medicare Advantage (MA). Democrats, however, questioned Secretary Kennedy on vaccine policy and spending cuts to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP).

He is also expected to testify before the Senate Appropriations subcommittee, the Senate HELP Committee, and the Senate Finance Committee soon.

To watch the House Ways & Means Committee hearing, CLICK HERE.

To watch the House Appropriations Committee hearing, CLICK HERE.

Center for American Progress Unveils Policy Plan Focusing on Prior Authorization, High Hospital Costs
The Center for American Progress (CAP), a left-leaning think tank, recently unveiled a policy plan titled “A Patient’s Bill of Rights to Lower Health Care Costs” that is aimed at reducing premiums, deductibles, and insurance denials. The plan offers a glimpse into Democrats’ healthcare priorities in a midterm election year.

The plan calls for replacing prior authorization with independent clinical review. “By replacing prior authorization with independent clinical review, evidence-based criteria, real-time clinical decision support and peer benchmarking, CAP expects that utilization will be better managed so that costs do not increase,” the group said. “At the same time, the administrative costs of prior authorization would decline significantly.”

CAP also aims to limit excessive premium increases and lower deductibles by reducing outlier hospital prices and preventing price gouging by insurance companies.

To read CAP’s plan, CLICK HERE.