Health Policy Report – November 19, 2024

Texas Oncology Meets with Lt. Gov Dan Patrick and Congresswoman Lizzie Fletcher

On October 24, Texas Oncology met with Lieutenant Governor Dan Patrick in Austin to discuss the pivotal role of community oncology in the state. Leaders from Texas Oncology spoke with the Lieutenant Governor about a range of issues, focused on the importance of delivering high-quality, cost-effective cancer care in a community setting to help patients stay close to home and connected with their families during treatment.

On October 28, leaders from Texas Oncology alongside representatives from The US Oncology Network met with Congresswoman Lizzie Fletcher (D-TX) in Houston. The group discussed the importance of accessible, high-quality, and affordable community cancer care in the Houston area and throughout the state. A member of the House Energy and Commerce Committee, Congresswoman Fletcher expressed her support for ongoing healthcare initiatives that benefit her constituents.

The US Oncology Network looks forward to working with state and federal lawmakers on issues impacting community oncology patients in Texas.

If you are interested in hosting a site visit for your state representative or state senator, please contact Angela.Storseth@usoncology.com.

To read more about Lt. Governor Patrick’s meeting with Texas Oncology, CLICK HERE.

To read more about Congresswoman Fletcher’s meeting with Texas Oncology and The US Oncology Network, CLICK HERE.

As Trump Administration Comes Together, Experts Predict Health Policy Changes 

Health policy experts are predicting how the federal government’s priorities may shift under the incoming administration. On November 14, President-elect Trump announced that he would appoint Robert F. Kennedy, Jr. as Secretary of the Department of Health and Human Services (HHS). During his presidential bid, Kennedy vowed to “combat the chronic disease epidemic” in the country using his wide-ranging “Make America Healthy Again” platform, which focuses on limiting pesticides and processed foods, and curbing the influence of drugmakers. Kennedy likely faces a steep slope to confirmation in the Senate.

Republican health priorities will likely include increased healthcare transparency and lowering drug costs. President-elect Trump has spoken out on other aspects of the Inflation Reduction Act (IRA), but he has not stated whether he supports rescinding the law’s drug price negotiation provision. However, the vast majority of Republicans in Congress want to repeal the drug pricing provisions of the IRA, which passed without a single Republican vote. 

During a conference held by America’s Physician Groups (APG), Alex Azar, who headed HHS during Donald Trump’s first administration, suggested the President-elect might support keeping Medicare’s authority to negotiate lower prices.

To read more, CLICK HERE.

To read more, CLICK HERE.

Congress Holds Leadership Elections, Looks Toward Site Neutral Reform

Lawmakers returned to the Capitol on November 12 to hold leadership elections and begin work on a long list of healthcare priorities. 

Republicans have officially secured control of both chambers of Congress, with a three-seat majority in the Senate and a slim majority in the House of Representatives. On November 14, Senate Republicans formally elected Senator John Thune (R-SD) as Senate Majority Leader, replacing longtime Republican leader Mitch McConnell (R-KY). As a senior member of the Finance Committee, Thune is well-versed on Medicare and Medicaid issues. This session, he’s been particularly focused on the 340B program, working with a bipartisan group of five other senators on a legislative framework to bolster transparency within the program. 

Meanwhile, House Republicans voted unanimously to make Speaker Mike Johnson (R-LA) their speaker nominee. An official floor vote to confirm him as Speaker for the upcoming session is expected to take place on January 3.

While site neutral payment reforms remain in play for a potential end-of-year funding package, health policy experts also see an opportunity for legislation to advance next year under a unified Republican Congress. Site neutral payment reforms are projected to save the government billions of dollars per year, which could help reduce the deficit impact of renewing lower taxes, a long-standing Republican priority.

To read more about Senator Thune’s health policy priorities, CLICK HERE.

ASCO Analysis Reveals Impact of PFS Final Rule on Oncology, Patient Groups Send Letter to Congress on MPFS Reform

The American Society of Clinical Oncology (ASCO) recently published an in-depth analysis of the Medicare Physician Fee Schedule Final Rule set by the Centers for Medicaid & Medicare Services (CMS), finding that the changes will result in a 4% cut to Medicare reimbursement for medical oncology, a 3.25% cut for radiation oncology, and a 3.6% cut for gynecologic oncology services.

Oncology reimbursement cuts will stem largely from a 2.83% reduction in the Conversion Factor (CF) for physician services. The Medicare Patient Access and Practice Stabilization Act (H.R. 10073) recently proposed in the House of Representatives would cancel the CF reduction and replace it with a minor increase to partially account for inflation. Additional changes that will affect oncology reimbursement through Medicare include adjustments to work relative value units for certain services and the expiration of the Physician Work Geographic Practice Cost Index.

ASCO cited CMS’s projection that its Medicare Economic Index (MEI) will increase by 3.5% this coming year and urged lawmakers to pass the Medicare Patient Access and Practice Stabilization Act to prevent oncologist reimbursement from falling even further as costs continue to rise.

On November 18, over thirty patient advocacy groups sent a letter to bipartisan leaders in the House and Senate urging Congress to address destabilizing trends in Medicare reimbursement.

“Lagging Medicare reimbursement has serious consequences. As costs rise and payments decline, more physicians’ offices are deciding to stop accepting new patients or to cut back on services. Worse, we fear that some practices may stop taking Medicare beneficiaries or close altogether. This would have an adverse impact on patients, especially in rural and underserved areas,” the groups wrote.

The letter is the latest in a push for Congress to mitigate the proposed cut to the Physician Fee Schedule (PFS) for 2025 and to address long-term reform. 

To read the letter to Congress, CLICK HERE.

To read ASCO’s report, CLICK HERE.

To ask your Member of Congress to support legislation addressing Medicare cuts to physician reimbursement, CLICK HERE.

OIG Report Finds Transparency Lacking Among Some Hospitals

According to a new report from the Health and Human Services Department’s Office of the Inspector General (OIG), many hospitals are not in compliance with a 2021 law that requires hospitals to publicly post their prices. 

The OIG analyzed data from 100 hospitals, a third of which did not post machine-readable pricing data files correctly or at all. Most of the violations involved failure to disclose the rates that hospitals negotiated with insurers, metadata errors, and outdated information. The Centers for Medicare & Medicaid Services (CMS) said that 11 of the 37 hospitals flagged for noncompliance have already corrected their mistakes and are under the agency’s review. 

To read more, CLICK HERE. 

To read the report, CLICK HERE.