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Oncology Practice Insider

ASCO’s Oncology Practice Insider provides the latest news, information, and educational tools to assist with the successful management of oncology practice and the delivery of high quality patient care. OPI offers updates on ASCO programs, services, and cancer-related health policy, Medicare news, and billing and coding best practices. To sign up for the biweekly Oncology Practice Insider newsletter, please complete this form.

ASCO members have identified the use of “co-pay accumulators” and “co-pay maximizers” as an area of growing concern. When these programs are in place, drug manufacturers’ co-pay assistance programs no longer apply toward patient co-pays or out-of-pocket maximums—resulting in out-of-pocket costs going up and required deductibles taking longer to reach. In response to its members’ concerns, ASCO created a new policy brief to help explain the full impact of these programs.
As payers search for ways to control the rising cost of care, “utilization management" policies such as prior authorization and step therapy have emerged as ways to restrict, limit, or deny coverage for certain treatments. ASCO recently developed a media issue brief identifying common payer-imposed utilization management practices, the impact of these policies on people with cancer, and evidence-based ways to help ensure the appropriate utilization of anti-cancer drugs and the delivery of high-quality care.
In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses findings from the ASCO 2019 National Cancer Opinion Survey, which found that only one in four Americans are taking concrete steps to prevent cancer, even though evidence exists that as many as half of all cancer cases are preventable. Further, the survey found that while 6 in 10 adults report being concerned about developing cancer, 25% believe that there is nothing they can do to prevent cancer. The survey also revealed troubling behaviors and attitudes around e-cigarette usage and end-of-life care.
Senators Lisa Murkowski (AK), Doug Jones (AL), and Bill Cassidy, MD (LA) introduced S. 2546, the Safe Step Act of 2019, in the U.S. Senate. If enacted into law, the bill would ensure patients with private insurance have reasonable protections against harmful step therapy practices.
An AMA sign-on letter was sent to the Hill on Thursday, October 17 addressing the issue of surprise medical bills. The letter included recommendation for maintaining marketplace balance while protecting patients from unexpected coverage gaps, and specifically addresses the structure of the independent dispute resolution process.
ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to a proposed rule that would loosen state reporting requirements and potentially threaten access to cancer care for Medicaid beneficiaries. ASCO believes all patients should have access to high-quality, high-value cancer care and is concerned that CMS’ proposal would jeopardize that access.
The latest ASCO in Action Podcast episode highlights ASCO’s 2019 Advocacy Summit during which oncology care providers from across the United States came to Capitol Hill to urge Members of Congress to support policies that will improve access to high-quality, high-value care for people with cancer. Specifically, ASCO volunteers asked Members of Congress to support:
In a letter to the Centers for Medicare & Medicaid Services (CMS), ASCO President Howard A.