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ASCO Submits Comments on Medicare Physician Fee Schedule Proposed Rule

Oncology Practice Insider

ASCO submitted in depth comments highlighting its concerns and recommending potential solutions in response to the 2019 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program (QPP) proposed rule. In the letter, ASCO warned the Centers for Medicare and Medicaid Services (CMS) that certain provisions of the fee schedule proposed rule will undermine access to cancer care for Medicare beneficiaries through a combination of payment reductions. The rule also lays out program rules for the third QPP performance year. For the first time, QPP adjustments will be applied as adjustments to MPFS physician payments in 2019. Between the MPFS policies and the QPP adjustments, even those physicians who performed well in year one of the QPP could see a 2% decrease in reimbursement. 

ASCO’s Patient-Centered Oncology Payment (PCOP) program model is designed to address the many challenges facing the cancer care delivery system today, since it adheres to value-based clinical pathways, and better aligns physician reimbursement with the full range of services needed to treat patients with cancer.

ASCO has long held that multiple Advanced APMs are needed in oncology to promote patient access to care and foster value-based approaches to treating cancer. ASCO urges CMS to expand and promote strategies that support oncology care, and in turn, some of the most complex—and costly—conditions Medicare beneficiaries face. Innovation that comes from designing alternative payment models would enhance both the quality and cost effectiveness of the care patients receive.

In conjunction with ASCO’s comment letter, twelve of ASCO’s State Affiliates submitted comment letters to CMS. Additionally, ASCO continues to meet with CMS officials on our concerns, as well as continuing member education efforts.