On Wednesday, September 14, the House of Representatives passed the Improving Seniors' Timely Access to Care Act. This Act aims to streamline prior authorization practices within the Medicare Advantage (MA) program by creating an electronic prior authorization process, holding MA plans accountable for the timeliness of determinations, improving transparency by requiring MA plans to report to CMS on the extent of their prior authorization use, and prohibiting additional prior authorization for added medically necessary services performed during an invasive procedure that already received prior authorization.

Now is the time to urge your Senators to support passage in the Senate! Please urge your Senators to act on this legislation.

The bill would:

• Create an electronic prior authorization process
• Hold MA plans accountable for the timeliness of determinations
• Improve transparency by requiring MA plans to report to CMS on the extent of their prior authorization use
• Prohibit additional prior authorization for added medically necessary services performed during an invasive procedure that already received prior authorization

Medicare providers are once again set to face another round of significant payment cuts if Congressional action is not taken prior to January 1, 2023. The recently released CY23 Medicare Physician Fee Schedule (MPFS) proposed rule jeopardizes the financial stability of many physician practices by proposing to cut the Medicare conversion factor by approximately 4.5%. These cuts, combined with the pending threat of the 4% PAYGO reduction and the termination of the 2% sequestration moratorium in July 2022, create for a nearly 10% reduction in revenue.

The Association for Clinical Oncology (ASCO), along with the entire House of Medicine, is asking Congress to take the following action to address the proposed cuts:

• Provide at least a 4.5% conversion factor adjustment for 2023
• Waive the 4% statutory PAYGO requirement
• Eliminate the 2% sequestration cuts to Part B services
• Provide a one-year inflationary update based on the Medicare Economic Index 

It is vital that Congress takes action to provide financial stability for Medicare providers and help ensure that seniors continue to have access to high quality care.

Visit the ACT Network and urge lawmakers to support financial stability for Medicare providers in FY23, and work with stakeholders to establish long-term payment reform.

Please join the Association for Clinical Oncology in supporting the Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act (H.R. 5030 / S.2706), introduced by Representatives Raul Ruiz, M.D. (D-CA-36) and Larry Bucshon, M.D. (R-IN-8), and Senators Robert Menendez (D-NJ) and Tim Scott (R-SC). This bill would result in more efficient, inclusive, and accessible research that will benefit the health of all patients by allowing trial sponsors to cover ancillary costs of trial participation and issue guidance on how to conduct decentralized clinical trials to improve demographic diversity. The support of this legislation is in alignment with ASCO's State Affiliate Council's priorities. Specifically, the legislation would:

• Allow individuals to receive financial support for the non-medical costs associated with their participation in clinical trials by creating a statutory safe harbor for trial sponsors to use in reimbursing such costs;
• Allow trial sponsors to provide individuals with the technology necessary for them to participate remotely in clinical trials. Clinical trials almost always require participants to report their condition, symptoms, side effects, or other data on a regular basis and/or have certain health indicators monitored by web-enabled technology;
• Require the Department of Health and Human Services (HHS) to issue guidance on decentralized clinical trials. While the COVID-19 pandemic accelerated the need for clinical trials in which patients could participate at or close to home, researchers have long endeavored to make clinical trials more convenient for participants. The decentralized approach could open the door to clinical trials for a much broader array of participants, such as those who live hours from a trial site or do not have the ability to make repeated visits to the trial site due to work or caregiving schedules.

You, your colleagues, and members of your state societies can submit letters to your members of Congress in under a minute.

As you know, children with cancer face many unique health challenges, and it is important that Congress prioritize funding for childhood cancer research and work to eliminate unnecessary barriers to care. Along with other cancer care organizations, ASCO is looking to increase Congressional support for two bills that will ensure continued funding for childhood cancer research and mitigate barriers to accessing necessary care outside a child’s home state.

The Childhood Cancer Survivorship, Treatment, Access and Research (STAR) Reauthorization Act (H.R. 7630 / S. 4120), would reauthorize federal funding for STAR Act programs for the next five years, maintaining federal investment in childhood cancer research.

The Accelerating Kids’ Access to Care Act (H.R. 3089 / S. 1544), would eliminate barriers in Medicaid so children with cancer can access the necessary cancer care outside of their home state.

Learn more and ask your lawmakers to support these important childhood cancer bills 

On Wednesday, July 27, the House Ways and Means Committee marked up and passed out of committee the Improving Seniors' Timely Access to Care Act (H.R. 3173 / S. 3018). This Act aims to streamline prior authorization practices within the Medicare Advantage (MA) program by creating an electronic prior authorization process, holding MA plans accountable for the timeliness of determinations, improving transparency by requiring MA plans to report to CMS on the extent of their prior authorization use, and prohibiting additional prior authorization for added medically necessary services performed during an invasive procedure that already received prior authorization. Action on prior authorization is a top priority for the Association for Clinical Oncology (ASCO) and has strongly supported this legislation—including the Advocacy Summit and Advocacy at Home asks. Thanks to the tireless work of ASCO volunteers, the Improving Seniors' Timely Access to Care Act has 309 cosponsors in the House and 39 in the Senate.

Please encourage your members to urge their lawmakers to act on prior authorization via the ACT Network. 

On July 27, 2022, the House of Representatives passed the Advancing Telehealth Beyond COVID–19 Act of 2021 (H.R.4040). The bill, which was introduced by Representatives Liz Cheney (R-WY-AL) and Debbie Dingell (D-MI-12), would extend telehealth flexibilities for two years, through the end of 2024.

Specifically, the legislation would:

• remove geographic and originating site restrictions • expand providers who can offer telehealth service—including physician assistants, nurse practitioners, and others
• allow Medicare reimbursement of telehealth services provided by physicians and practitioners working for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs)
• allow audio-only telehealth services 
• expand access to telehealth services for the recertification of hospice care eligibility during an emergency period.

The bill has moved to the Senate, where its path forward is unclear. While there is broad support for extending telehealth flexibilities beyond the COVID-19 Public Health Table of Contents Encourage your members to join the State Society Network Emergency, a full agenda and limited legislative days are creating obstacles. 

We encourage our members to contact their lawmakers and urge them to make the telehealth flexibilities established during the pandemic permanent.