US Oncology Government Relations Action Alert

CMS Releases Proposed Rule for 2013 Medicare Physician Fee Schedule 

On July 6, 2012 CMS posted the Proposed Rule for the 2013 Medicare Physician Fee Schedule (MC-PFS).  The official notice will be published in the Federal Register on July 30th and will remain open for comment until September 4th.  Once again, it is important to recognize that, absent congressional action, payments for all services to Medicare patients will be reduced by 27% in 2013 due to the operation of the Sustainable Growth Rate (SGR) formula.

Key changes in payment policy outlined in the Proposed Rule include:

  • A Conversion Factor (CF) of $24.8441 (current CF is $34.0376).
  • Increasing payments by 7% for family practice physicians and between 3-5 % for other practitioners providing primary care services through the establishment of a new care management procedure code.  Because of the MC-PFS requirement for budget neutrality, this change comes at the expense of payment reductions for other procedure codes.
  • Reducing procedure time assumptions used to develop the Practice Expense (PE) RVUs for intensity modulated radiation treatment (IMRT, CPT 77418) from 60 minutes to 30 and for stereotactic body radiation therapy delivery (SBRT, CPT 77373) from 90 minutes to 60.
  • Targeting of CPT codes for other forms of radiation therapy delivery that are PE only codes for RUC review of procedure time assumptions and potential adjustment as misvalued codes in 2014.
  • Reducing the interest rate assumptions used to establish payments for practice expenses – a change that has its largest impact on procedures such as advanced imaging and radiation therapy that are highly dependent on expensive capital equipment.
  • Providing an exception to the existing rules requiring payment at 103% of AMP in lieu of 106% of ASP in certain instances when ASP exceeds AMP by 5% if a particular drug and dosage form have been designated as a shortage item.
  • Removing the current prohibition against complex prepayment medical reviews of claims filed by physicians who have failed to reduce their individual error rates.
  • Requesting comment on whether the provision of molecular pathology services involves sufficient physician work to justify payment under the MC-PFS instead of the Clinical Laboratory Fee Schedule.

Excluding the 27% reduction of the CF, CMS estimates that total allowable charges for services furnished by rheumatologists and gastroenterologists will not decrease in 2013 but payments to medical oncologists and dermatologists will be reduced by 1% and those for diagnostic imaging services will be 4% lower.  The impact of the proposed rule on radiation oncology is projected to be a payment cut of 15%, with entities having a specialty code of radiation therapy center in the Medicare physician/supplier enrollment file experiencing an even more dramatic 19% reduction.  

Practices will again receive 0.5% payment bonuses for successful participation in the Physician Quality Reporting System (PQRS) program in 2013.  Key changes to the PQRS, the Electronic Prescribing (eRx) Incentive Program, and the PQRS-Medicare Electronic Health Record (EHR) Pilot in the proposed rule are aimed at expanding the measures available for reporting and further easing the reporting burden.  These changes include:

  • Adding a number of new measures focused on oncology.
  • Aligning criteria for PQRS reporting using EHRs with those for meeting the clinical quality measures (CQMs) component of meaningful use under the EHR Incentive Program.
  • Decreasing the minimum threshold of patients on which eligible professionals are required to report using measures groups via registry from 30 to 20 under PQRS.  
  • Defining satisfactory PQRS reporting for 2015 as reporting 1 PQRS measure or measures group.
  • Expanding the definition of group practice to include groups of 2-24 eligible professionals for purposes of PQRS reporting under the Group Practice Reporting Option (GPRO) and for being a successful electronic prescriber using the eRx GPRO.
  • Continuing the use of the attestation method and the PQRS-Medicare EHR Pilot for reporting CQMs established last year only for 2012.

The proposed rule continues CMS’ implementation of value-based purchasing.  For practices with 25 or more eligible professionals, 2013 will be the base year for assessing payments under the value modifiers that will be applicable in 2015.  Implementation of value-based purchasing will begin later for smaller groups and solo practitioners.

  • The value-based modifier for practices that satisfactorily report under PQRS will be set at 0.0 unless the group elects to have its modifier calculated using a quality tiering approach.
  • Under quality tiering, a practice would earn an upward payment adjustment of 2% for high-quality, low-cost performance, a downward adjustment of minus 1% for low-quality, high-cost performance, and smaller adjustments either upward or downward for other quality/cost combinations.
  • Practices will receive Physician Feedback reports based on 2012 data that preview their modifier prior to the deadline for electing the quality-tiering approach.
  • The value-based modifier for practices that fail to satisfactorily report under PQRS will be set at minus 1.0%. This reduction will be in addition to the 1.5% reduction that will apply in 2015 to all eligible professionals who fail to satisfactorily report under PQRS.

The US Oncology Network will submit comments on the 2013 Medicare Physician Fee Schedule proposed rule by September 4, 2012.  The final rule is expected on November 1st and will become effective January 1, 2013.


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LegisLink Today

Health Policy Report - Oct. 18, 2017
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                                  Health Policy Report - March 22, 2017
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                                      Health Policy Report - March 8, 2017
                                      • • House Republicans Introduce ACA Repeal and Replace Bill
                                      • • Seema Verma Approved by Senate Finance Committee
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                                          • • Bipartisan Legislation Aims to Tackle DIR Fees
                                          • • Tom Price, MD Confirmed as HHS Secretary
                                          • • CMS Nominee Testifies Before Senate Finance Committee
                                          • • House Republicans Release ACA Replacement Plan

                                              Health Policy Report - Jan. 25, 2017
                                              • • President Trump Signs Executive Order Facilitating ACA Repeal
                                              • • Congress Passes Budget Resolution with ACA Repeal Instructions
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                                                  Health Policy Report - Nov. 16, 2016
                                                  • • The US Oncology Network Meets with Cancer Moonshot Leaders
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                                                  • • President-Elect Trump Taps Former Officials for HHS Transition
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                                                      Health Policy Report - Nov. 3, 2016
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                                                      • • Senate Finance Members Released Bipartisan Proposal on Chronic Care Improvement
                                                      • • CBO Submits Answers on Budgetary Effects of the Center for Medicare & Medicaid Innovation

                                                          Health Policy Report - Oct. 19, 2016
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                                                              Health Policy Report - Oct. 5, 2016
                                                              • • House Republicans Ask CMS to Halt CMMI Mandatory Demonstrations
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                                                              • • Lawmakers to Prioritize 21st Century Cures Legislation in Lame Duck Session

                                                                  Health Policy Report - Sept. 21, 2016
                                                                  • • Alliance for Site Neutral Payment Reform Launches New Website
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                                                                  • • MedPAC Examines Physician Affiliation and Practice Size
                                                                  • • Physician Advocate Institute: Hospital Ownership of Physician Practices Increases Nearly 90 Percent in Three Years
                                                                  • • New Health Affairs Report on Physician Consolidation Shows Rapid Movement from Small to Large Group Practices

                                                                      Health Policy Report - Sept. 9, 2016
                                                                      • • Breaking News: CMS Makes MACRA Announcement
                                                                      • • The US Oncology Network Submits Comments to CMS on Proposed Medicare Payment Rules for CY2017
                                                                      • • Alliance for Site Neutral Payment Reform Submits Comments to CMS on Outpatient Prospective Payment System for CY2017
                                                                      • • Bipartisan Lawmakers Ask HHS Secretary for Flexibility in Implementation of MACRA
                                                                      • • House Budget Committee Holds Hearing on CMMI Programs and Spending

                                                                          Health Policy Report - July 27, 2016
                                                                          • • CMS Acting Administrator Suggests Possible MACRA Delay at Senate Hearing
                                                                          • • Senate Finance Committee Holds Hearing on Stark Law
                                                                          • • Department of Justice Moves to Block Insurance Mergers
                                                                          • • GOP Releases 2016 Platform
                                                                          • • Virginia Cancer Specialists First in the World to Enroll Patient in Cutting-Edge Lung Cancer Clinical Trial

                                                                              Health Policy Report - July 12, 2016
                                                                              • • The US Oncology Network Applauds Site Neutral Policies in 2017 OPPS Proposed Rule
                                                                              • • CMS Releases Proposed Physician Fee Schedule Rule for 2017
                                                                              • • The US Oncology Network Practices Selected for Participation in Oncology Care Model
                                                                              • • NIH Announces Grants to Support Precision Medicine Initiative
                                                                              • • Virginia Cancer Specialists Receives Clinical Trials Research Award from Conquer Cancer Foundation

                                                                                  Health Policy Report - June 29, 2016
                                                                                  • • USON’s Dr. Debra Patt Pens Column on Importance of Site Neutral Payment Reforms
                                                                                  • • Senate Finance Committee Examines Medicare Part B Drug Payment Model
                                                                                  • • MedPAC Releases Report to the Congress
                                                                                  • • HHS’ OIG Report Recommends Equalization of Payments Across Settings
                                                                                  • • Medicare Board of Trustees Release Annual Report

                                                                                      Health Policy Report - June 15, 2016
                                                                                      • • Opposition to Medicare Part B Drug Payment Model Continues to Mount
                                                                                      • • CMS Responds to Lawmaker Concerns with Part B Drug Payment Model
                                                                                      • • U.S. House Passes Bill Amending Site Neutral Payment Provision
                                                                                      • • House Ways & Means Committee Holds Hearing on Medicare Legislation
                                                                                      • • Health Affairs Blog Highlights Need for Site Neutral Reforms
                                                                                      • • American Medical Association Releases MACRA Toolkit

                                                                                          Health Policy Report - June 1, 2016
                                                                                          • • Contact Your Member of Congress Today: Don't Undermine Site Neutral Payments!
                                                                                          • • House Ways and Means Committee Passes Bill with Hospital Site Neutral Exemptions
                                                                                          • • In the News: The US Oncology Network Opposes Medicare Part B Drug Demo
                                                                                          • • HRSA Delays Release of New 340B Guidance

                                                                                              Health Policy Report - May 20, 2016
                                                                                              • • Dr. Debra Patt Testifies at Energy & Commerce Committee Hearing on Part B Demo
                                                                                              • • Take Action: Urge Your Lawmaker to Cosponsor H.R. 5122
                                                                                              • • USON PAC Board Visits Capitol Hill
                                                                                              • • The US Oncology Network Submits Comments to CMS on Medicare Part B Drug Payment Model
                                                                                              • • More Bipartisan Lawmakers Express Concerns to CMS with Part B Drug Demo
                                                                                              • • Slavitt Testifies at Ways & Means Hearing on MACRA

                                                                                                  Health Policy Report - May 5, 2016
                                                                                                  • • Bipartisan Lawmakers Warn Against Medicare Part B Drug Demonstration
                                                                                                  • • The US Oncology Network Joins Provider and Patient Groups in Opposing Part B Cuts
                                                                                                  • • CMS Releases Proposed Rule for New Medicare Physician Payment System
                                                                                                  • • Site Neutral Bill Introduced in Vermont Legislature
                                                                                                  • • Inside Sources: Medicare Policies Pushing Outpatient Costs Higher

                                                                                                      Health Policy Report - April 21, 2016
                                                                                                      • • REMINDER! Contact Your Member of Congress to Protect Cancer Patients!
                                                                                                      • • GAO: Equalize Pay Across Settings to Reduce Medicare Costs
                                                                                                      • • MedPAC Holds Public Meeting on Medicare Part B Drug and Oncology Payment Policy Issues
                                                                                                      • • House Energy and Commerce Subcommittee on Health Holds Meeting to Discuss MACRA
                                                                                                      • • CMS Announces New Primary Care Initiative

                                                                                                          Health Policy Report - April 7, 2016
                                                                                                          • • Contact Your Member of Congress: Protect Cancer Patients!
                                                                                                          • • New Milliman Study: Cost Drivers of Cancer Care
                                                                                                          • • Alliance for Site Neutral Payment Reform Urges CMS to Expand Payment Parity Provisions
                                                                                                          • • Oncology Care Model Practices May Be Excluded from Part B Drug Payment Model

                                                                                                              Health Policy Report - March 24, 2016
                                                                                                              • • CMS Releases Proposed Rule for Medicare Part B Drug Payment Model
                                                                                                              • • Lawmakers, Cancer Care Leaders and Patient Advocates Oppose CMS’s Part B Test
                                                                                                              • • MedPAC Report Recommends Reduction in Medicare Part B Payments to 340B Hospitals
                                                                                                              • • House Budget Committee Passes FY2017 Budget Resolution

                                                                                                                  Health Policy Report - March 8, 2016
                                                                                                                  • • U.S. Oncology Network and Coalition Partners Urge CMS to Abandon Proposed Part B Drug Payment Model
                                                                                                                  • • U.S. Oncology Network Comments on Breakthrough Drug Pricing
                                                                                                                  • • MedPAC Discusses Part B Drug Pricing and Efficiency of FFS Oncology Services
                                                                                                                  • • AJMC Publishes National Estimates of Price Variation by Site of Care
                                                                                                                  • • HCCI Study Examines Impact of Consolidation on Cancer Drug Spending

                                                                                                                      Health Policy Report - February 24, 2016
                                                                                                                      • • The US Oncology Network and Coalition Partners Urge Expansion of Site Neutral Payment Policies
                                                                                                                      • • Avalere Study: Medicare Payments Three Times Higher in Outpatient Departments
                                                                                                                      • • CMS Mistakenly Posts Notice of New Part B Drug Payment Model
                                                                                                                      • • CMS & AHIP Release Clinical Quality Measures

                                                                                                                          Health Policy Report - February 12, 2016
                                                                                                                          • • Energy & Commerce Leaders Seek Comments on Site-Neutral Reform Provision
                                                                                                                          • • President Obama Releases FY2017 Budget Proposal
                                                                                                                          • • The US Oncology Network Submits Comments on Stark Law Improvements
                                                                                                                          • • US Oncology’s Dr. Seiden Examines the Challenges, Benefits and Risks of Immuno-Oncology in the American Journal of Managed Care

                                                                                                                              Health Policy Report - January 27, 2016
                                                                                                                              • • The US Oncology Network Submits Comments to Chronic Care Working Group
                                                                                                                              • • MedPAC Recommends Reducing Hospital Rates for 340B
                                                                                                                              • • MedPAC Discusses Alternative Payment Models
                                                                                                                              • • Senate HELP Committee Drafts New Health IT Legislation

                                                                                                                                  Health Policy Report - December 22, 2015
                                                                                                                                  • • Congress Averts Cuts to Radiation Therapy
                                                                                                                                  • • Congress Passes Omnibus Spending Bill
                                                                                                                                  • • GAO Recommends Payment Reform to Curb Hospital-Physician Consolidation

                                                                                                                                      Health Policy Report - December 9, 2015
                                                                                                                                      • • OIG Report Finds Hospitals Profit from 340B Cancer Drugs
                                                                                                                                      • • Senate Passes Reconciliation Package
                                                                                                                                      • • CMS Releases 2014 National Health Spending Report

                                                                                                                                          Health Policy Report - November 20, 2015
                                                                                                                                          • • Coalition Holds Congressional Briefing on Site-Neutral Payment Reform
                                                                                                                                          • • Healthcare Stakeholders Submit Comments on MACRA
                                                                                                                                          • • New ACS Report On Cancer Drug Coverage and Transparency

                                                                                                                                              Health Policy Report - November 4, 2015
                                                                                                                                              • • CMS Releases Final Rule for 2016 Medicare Physician Fee Schedule
                                                                                                                                              • • President Obama Signs Budget Deal with Site-Neutral Payment Provision
                                                                                                                                              • • Medicare Scales Back Claims Review Program
                                                                                                                                              • • 340B Comments Submitted To HRSA On ‘Mega-Guidance’
                                                                                                                                              • • Ways & Means Chairmanship Vacant After Ryan Elected Speaker

                                                                                                                                                  Health Policy Report - September 23, 2015
                                                                                                                                                  • • Site-Neutral Payment Reforms Cited as Possible Sequester Offset Solution
                                                                                                                                                  • • New Report Finds 340B Growth Larger than Previously Understood
                                                                                                                                                  • • Congressional Hearing Examines Healthcare Consolidations
                                                                                                                                                  • • New CMS Equity Plan Seeks to Reduce Health Disparities in Medicare

                                                                                                                                                      Health Policy Report - September 10, 2015
                                                                                                                                                      • • TAKE ACTION! Ask Congress to Help Stop Proposed Medicare Cuts to Cancer Care
                                                                                                                                                      • • NHRSA Releases 340B Discount Drug Program Guidance
                                                                                                                                                      • • New CBO Projections Predict Lower Long-Term Medicare Spending
                                                                                                                                                      • • CMS Studies Shift Toward Hospital-Based Physician Practices

                                                                                                                                                          Health Policy Report - August 13, 2015
                                                                                                                                                          • • Dr. Barry Brooks: Equalize Payment Across Site of Service
                                                                                                                                                          • • New Report Shows States Falling Behind in Efforts to Prevent Cancer
                                                                                                                                                          • • Senate Finance Committee Posts 530 Submissions to Chronic Conditions Work Group
                                                                                                                                                          • • Bipartisan Think Tank Recommends Near-Term Improvements to ACO Model

                                                                                                                                                              Health Policy Report - July 29, 2015
                                                                                                                                                              • • Ways & Means Committee Examines Hospital Site Neutral Payment Reforms
                                                                                                                                                              • • More than 100 Oncologists Call for Lower Drug Prices in Letter to Policymakers
                                                                                                                                                              • • Senator Grassley Calls for 340B Hearings for Unintended Consequences
                                                                                                                                                              • • Medicare Depletion Date Expected at 2030

                                                                                                                                                                  Health Policy Report - July 15, 2015
                                                                                                                                                                  • • CMS Releases Proposed Rule for 2016 Medicare Physician Fee Schedule
                                                                                                                                                                  • • U.S. House Passes 21st Century Cures Legislation
                                                                                                                                                                  • • GAO Study: Eliminate Incentives for Expensive Drugs at 340B Hospitals
                                                                                                                                                                  • • CMS Helps Physicians Transition to ICD-10 with 12-Month Safe Harbor Period, Ombudsman, and Training

                                                                                                                                                                      Health Policy Report - June 30, 2015
                                                                                                                                                                      • • Bipartisan Bill to Equalize Medicare Payments for Cancer Care Introduced in the House
                                                                                                                                                                      • • GOP Doctors Caucus Seeks to Preserve Medicare Self-Referral Exception
                                                                                                                                                                      • • U.S. Supreme Court Upholds Insurance Subsidies in King v. Burwell

                                                                                                                                                                          Health Policy Report - June 3, 2015
                                                                                                                                                                          • • Federal Government Releases 2013 Medicare Billing Data
                                                                                                                                                                          • • Senate Finance Leaders to Explore Improved Delivery of Chronic Care
                                                                                                                                                                          • •NIH Announces Nationwide Precision Medicine Trial for Cancer Patients
                                                                                                                                                                          • • Senate Finance Committee Examples Medicare Audit and Appeals Reforms

                                                                                                                                                                              Health Policy Report - May 21, 2015
                                                                                                                                                                              • • Energy & Commerce Committee Releases Updated 21st Century Cures Legislation; 340B Reform Measure Not Included
                                                                                                                                                                              • • Connecticut Senate Bill Proposes Site-Neutral Payment Reforms
                                                                                                                                                                              • • Petition Calls for Expanded Copay Assistance Programs, Patient Access to Cancer Care
                                                                                                                                                                              • • IMS Institute Unveils Global Oncology Trend Report
                                                                                                                                                                              • • CDC Report: Cancer Screening Rates on Decline

                                                                                                                                                                                  Health Policy Report - May 6, 2015
                                                                                                                                                                                  • • TAKE ACTION: Ask Lawmakers to Oppose Proposal to Extend Sequestration Cuts
                                                                                                                                                                                  • • President Obama Signs Historic SGR Reform Legislation
                                                                                                                                                                                  • • CMS: Small Volume of Medicare Claims will be Impacted by SGR, Processed at Reduced Rate
                                                                                                                                                                                  • • MedPAC Analyzes Bundling Oncology Services
                                                                                                                                                                                  • • CMS Proposes Changes to EHR Incentive Program
                                                                                                                                                                                  • • April Health Affairs Focuses on Cancer Care
                                                                                                                                                                                  • • USPSTF Issues New Draft Recommendations on Breast Cancer Screening

                                                                                                                                                                                      Health Policy Report - April 23, 2015
                                                                                                                                                                                      • • TAKE ACTION: Ask Lawmakers to Oppose Proposal to Extend Sequestration Cuts
                                                                                                                                                                                      • • President Obama Signs Historic SGR Reform Legislation
                                                                                                                                                                                      • • CMS: Small Volume of Medicare Claims will be Impacted by SGR, Processed at Reduced Rate
                                                                                                                                                                                      • • MedPAC Analyzes Bundling Oncology Services
                                                                                                                                                                                      • • CMS Proposes Changes to EHR Incentive Program
                                                                                                                                                                                      • • April Health Affairs Focuses on Cancer Care
                                                                                                                                                                                      • • USPSTF Issues New Draft Recommendations on Breast Cancer Screening

                                                                                                                                                                                          Health Policy Report - April 1, 2015
                                                                                                                                                                                          • • US House Passes Bipartisan Bill to Repeal SGR
                                                                                                                                                                                          • • Senate, House Pass Budget Resolutions
                                                                                                                                                                                          • • House Energy and Commerce Committee Examines 340B Program
                                                                                                                                                                                          • • New Study Refutes Claims that Self-Referral Encourages Inappropriate Utilization or Increased Medicare Spending
                                                                                                                                                                                          • • GAO Analyzes Medicare Payments to Certain Cancer Hospitals

                                                                                                                                                                                              Health Policy Report - March 20, 2015
                                                                                                                                                                                              • • Congress Introduces Bipartisan Bill to Repeal SGR
                                                                                                                                                                                              • • MedPAC Once Again Recommends Site-Neutral Payment Reform
                                                                                                                                                                                              • • Medicare to Publish Physician-Payment Data Next Month
                                                                                                                                                                                              • • U.S. Supreme Court Examines Health Insurance Subsidies in King v. Burwell
                                                                                                                                                                                              • • HHS Unveils Next Generation Accountable Care Organization Model
                                                                                                                                                                                              • • CDC Unveils Report on Invasive Cancer Incidence and Survival
                                                                                                                                                                                              • • Maryland Legislature Considers Law Allowing Integrated Cancer Care
                                                                                                                                                                                              • • CMS Considers Expansion of Coverage for PET Cancer Scans

                                                                                                                                                                                                  Health Policy Report - February 26, 2015
                                                                                                                                                                                                  • • The US Oncology Network’s Dr. Barry Brooks Pens Op-Ed Highlighting Need for Site-Neutral Medicare Payment Reform
                                                                                                                                                                                                  • • HHS Unveils New Payment Model for Cancer Care
                                                                                                                                                                                                  • • Prompt Pay Discount Legislation Introduced in U.S. House
                                                                                                                                                                                                  • • CMS Approves Medicare Coverage for Lung Cancer Screening
                                                                                                                                                                                                  • • CBO Releases Higher SGR Replacement Cost Estimate
                                                                                                                                                                                                  • • Lawmakers Debate Preparedness for ICD-10 Transition

                                                                                                                                                                                                      Health Policy Report - February 5, 2015
                                                                                                                                                                                                      • • President Obama Endorses Site-Neutral Payment Policies in FY2016 Budget Proposal
                                                                                                                                                                                                      • • Obama Administration Releases Details of Precision Medicine Initiative
                                                                                                                                                                                                      • • 21st Century Cures Initiative Enters Legislative Phase
                                                                                                                                                                                                      • • HHS Unveils Plan to Revamp Medicare Payments
                                                                                                                                                                                                      • • HHS Asks DC Court To Drop 340B Orphan Drug Lawsuit

                                                                                                                                                                                                          Health Policy Report - January 23, 2015
                                                                                                                                                                                                          • • The US Oncology Network Joins New Alliance for Site-Neutral Payment Reform
                                                                                                                                                                                                          • • Energy and Commerce Committee Hearing Focuses on Future of SGR
                                                                                                                                                                                                          • • Obama Sets an Ambitious Agenda In State of the Union, Healthcare Not A Focus
                                                                                                                                                                                                          • • MedPAC Discusses Site-Neutral Payments, Hospital Reimbursement, and Physician Payment Rates

                                                                                                                                                                                                              Health Policy Report - January 7, 2015
                                                                                                                                                                                                              • • 114th Congress Convenes, Republicans Control Both Chambers of Congress
                                                                                                                                                                                                              • • 2014 Healthcare Policy Milestones & Trends
                                                                                                                                                                                                              • • Congress Raises Concerns about 340B
                                                                                                                                                                                                              • • MedPAC Shows Continued Support for Payment Parity
                                                                                                                                                                                                              • • Cancer Death Rates in U.S. Continue to Decline

                                                                                                                                                                                                                  Health Policy Report - December 10, 2014
                                                                                                                                                                                                                  • • Report: 340B Sales to Rise
                                                                                                                                                                                                                  • • National Media Outlets Examine Impact of Higher Hospital Costs on Cancer Care
                                                                                                                                                                                                                  • • Healthcare Spending Growth Slowed in 2013
                                                                                                                                                                                                                  • •U.S. House of Representatives Passes ABLE Act
                                                                                                                                                                                                                  • • CMS Proposes New ACO Regulation

                                                                                                                                                                                                                      Health Policy Report - November 20, 2014
                                                                                                                                                                                                                      • • MedPAC Examines Part B Drug Payment Policy
                                                                                                                                                                                                                      • • HRSA Pulls Back 340B 'Mega Rule’
                                                                                                                                                                                                                      • • Supreme Court to Hear Affordable Care Act Subsidies Case
                                                                                                                                                                                                                      • • Lawmakers, Physician Groups Seek SGR Reform in Lame Duck Session
                                                                                                                                                                                                                      • • CMS Proposed Lung Cancer Screening Coverage for High-Risk Beneficiaries
                                                                                                                                                                                                                      • • VA Reimbursement Rule Has Providers Fearing Slow Payment

                                                                                                                                                                                                                          Health Policy Report - November 4, 2014
                                                                                                                                                                                                                          • • CMS Releases Final Rule for 2015 Medicare Physician Fee Schedule
                                                                                                                                                                                                                          • • HRSA Asks Drug Manufacturers to Refund 340B Overcharges
                                                                                                                                                                                                                          • • Medical Costs Up to 20% Higher at Hospital-Owned Physician Groups, Study Finds
                                                                                                                                                                                                                          • • Supreme Court Not Taking Up Insurance Subsidies Lawsuit Yet
                                                                                                                                                                                                                          • • Simpler Home Test for Colon Cancer Offered

                                                                                                                                                                                                                              Health Policy Report - October 22, 2014
                                                                                                                                                                                                                              • • New COA Report Finds 82% Increase in Cancer Clinic Closings Since 2010
                                                                                                                                                                                                                              • • PhRMA Files Suit Challenging HHS Orphan Drug Regulation
                                                                                                                                                                                                                              • • Aunt Minnie Op-Ed: Payment parity in radiation therapy best serves cancer patients
                                                                                                                                                                                                                              • • JAMA Articles Illustrate Division Over Lung Cancer Screening
                                                                                                                                                                                                                              • • AMA Sends Blueprint to Strengthen the Meaningful Use Program to CMS

                                                                                                                                                                                                                                  Health Policy Report - October 8, 2014
                                                                                                                                                                                                                                  • • More than 160 Members of Congress Weigh in with CMS on Radiation Oncology Cuts
                                                                                                                                                                                                                                  • • Congress Breaks for Mid-Term Election Campaigning; Lame-Duck Session Approaching
                                                                                                                                                                                                                                  • • Health Affairs Report Findings Reinforce 340B Program Abuse Concerns
                                                                                                                                                                                                                                  • • Physician Groups Warn New Open Payments Site Contains Errors, Lack Accuracy
                                                                                                                                                                                                                                  • • Role of RUC in Assigning Medicare Payments Called into Question

                                                                                                                                                                                                                                      Health Policy Report - September 26, 2014
                                                                                                                                                                                                                                      • • Republican Lawmakers Call for Increased Transparency in Rule Making Process
                                                                                                                                                                                                                                      • • MedPAC Weighs Least-Costly Alternative Approaches To Control Part B Drug Prices
                                                                                                                                                                                                                                      • • CMS Releases Medicare ACO and Shared Savings Program Results
                                                                                                                                                                                                                                      • • Stakeholders Concerned Sunshine Act Data Release Lacks Needed Context and Background Information
                                                                                                                                                                                                                                      • • Bipartisan Bill Introduced in House to Extend Deadline to Show Meaningful Use of Electronic Health Records

                                                                                                                                                                                                                                          Health Policy Report - September 10, 2014
                                                                                                                                                                                                                                          • • Take Action Today! Encourage Congress to Stand Up Against Proposed Radiation Oncology Cuts
                                                                                                                                                                                                                                          • • The US Oncology Network Submits Formal Comments to CMS on Proposed Payment Policy Revisions
                                                                                                                                                                                                                                          • • Bipartisan House Energy & Commerce Health Subcommittee Leaders Ask CMS to Maintain Status Quo on Radiation Therapy Payments
                                                                                                                                                                                                                                          • • Open Payments Site Experiences Delays; Physicians Concerned
                                                                                                                                                                                                                                          • • District Court Upholds New Interpretive HRSA Rule on 340B Orphan Drug Exclusions
                                                                                                                                                                                                                                          • • New CMS Report Predicts Positive Trends in Healthcare Spending

                                                                                                                                                                                                                                              Health Policy Report - August 19, 2014
                                                                                                                                                                                                                                              • • CMS Releases Potential Innovative Oncology Payment Model
                                                                                                                                                                                                                                              • • New Veteran Affairs Bill Expands Private Practice Services to Veterans
                                                                                                                                                                                                                                              • • Physician Groups Concerned Open Payments Dispute Process Flawed
                                                                                                                                                                                                                                              • • RAND Analysis Recommends Review of 340B Program Processes
                                                                                                                                                                                                                                              • • 310,000 Enrollees To Lose Healthcare Coverage If Citizenship Not Verified

                                                                                                                                                                                                                                                  Health Policy Report - August 5, 2014
                                                                                                                                                                                                                                                  • • New Medicare Report: Improved Financial Outlook for Medicare Trust Fund
                                                                                                                                                                                                                                                  • • Bipartisan Lawmakers Express Support For 340B Program
                                                                                                                                                                                                                                                  • • The US Oncology Network Joins Cancer Care Advocates in Submitting USP Chapter <800> Comments
                                                                                                                                                                                                                                                  • • E&C Health Subcommittee Convenes Markup on Important Healthcare Legislation

                                                                                                                                                                                                                                                      Health Policy Report - July 23, 2014
                                                                                                                                                                                                                                                      • • Two U.S. Appeals Courts Issue Contradictory ACA Subsidies Rulings
                                                                                                                                                                                                                                                      • • HRSA Issues Interpretive Rule Maintaining 340B Orphan Drug Exclusion
                                                                                                                                                                                                                                                      • • CMS Proposes Eliminating CME Exclusion from Open Payments Program
                                                                                                                                                                                                                                                      • • Colon Cancer Care Advocates Urge Congress to Eliminate Colonoscopy Copay
                                                                                                                                                                                                                                                      • • Health Affairs Examines Future of “Big Data” in US Healthcare System

                                                                                                                                                                                                                                                          Health Policy Report - July 9, 2014
                                                                                                                                                                                                                                                          • • CMS Releases Proposed Rule Setting 2015 Medicare Physician Fee Schedule Payment Rates
                                                                                                                                                                                                                                                          • • HRSA Releases 340B Auditing Process Changes
                                                                                                                                                                                                                                                          • • Study Finds Cost of Care for Common Patient Services Doubles in HOPD
                                                                                                                                                                                                                                                          • • Open Payments System Registration for Physicians Begins Mid-Month

                                                                                                                                                                                                                                                              Health Policy Report - June 18, 2014
                                                                                                                                                                                                                                                              • • New Study Finds Shift To Hospital Setting Drives Up Cancer Costs
                                                                                                                                                                                                                                                              • • Alliance for Integrity and Reform of 340B Hosts National Leadership Summit to Discuss 340B Reforms
                                                                                                                                                                                                                                                              • • MedPAC Expands Support of Site Neutral Payments
                                                                                                                                                                                                                                                              • • Large Bipartisan Group of Lawmakers Urge Medicare Decision on Low-Dose CT Scans For Lung Cancer Screening

                                                                                                                                                                                                                                                                  Health Policy Report - June 4, 2014
                                                                                                                                                                                                                                                                  • • The US Oncology Network’s Barry Brooks Testifies Before House Energy & Commerce Health Subcommittee on Site-Neutral Medicare Payment Reform
                                                                                                                                                                                                                                                                  • • Court Decision Calls HRSA 340B Rule-Making Authority Into Question
                                                                                                                                                                                                                                                                  • • New Study Examines 340B Hospital Acquisitions of Physician-Based Oncology Practices
                                                                                                                                                                                                                                                                  • • CMS Issues Proposed Rule on “Meaningful Use” Requirements
                                                                                                                                                                                                                                                                  • • Senators Urge Medicare to Cover Lung Cancer Test
                                                                                                                                                                                                                                                                  • • Burwell Vote Likely this Week

                                                                                                                                                                                                                                                                      Health Policy Report - May 14, 2014
                                                                                                                                                                                                                                                                      • • IMS Institute: Higher Cancer Costs Due to Shift To Hospital Outpatient Facilities
                                                                                                                                                                                                                                                                      • • Stanford University Study Finds Hospital Ownership of Physician Practices Leads to Higher Prices
                                                                                                                                                                                                                                                                      • • CMS Confirms One-Year Delay of ICD-10 Code Transition
                                                                                                                                                                                                                                                                      • • Senate Holds Confirmation Hearings for HHS Secretary Nominee Burwell
                                                                                                                                                                                                                                                                      • • HHS: Health Insurance Marketplace Enrollment Exceeds 8 Million Americans

                                                                                                                                                                                                                                                                          Health Policy Report - April 30, 2014
                                                                                                                                                                                                                                                                          • • MARK YOUR CALENDAR! Virtual Hill Days May 7 & 8
                                                                                                                                                                                                                                                                          • • Jonathan Blum Announces CMS Departure
                                                                                                                                                                                                                                                                          • • Burwell Hearing Set
                                                                                                                                                                                                                                                                          • • Healthcare Coalition Urges CMS to Set Date for Implementation of ICD-10 Codes
                                                                                                                                                                                                                                                                          • • New Online Tool Available to Search Physician Payment Data

                                                                                                                                                                                                                                                                              Health Policy Report - April 16, 2014
                                                                                                                                                                                                                                                                              • • CMS Announces Release of Physician Payment Information
                                                                                                                                                                                                                                                                              • • Narrow Insurance Networks Could Threaten Patient Access to Specialized Cancer Care Centers
                                                                                                                                                                                                                                                                              • • HHS Secretary Kathleen Sebelius Steps Down
                                                                                                                                                                                                                                                                              • • House Passes Ryan Budget Resolution; Action Not Likely in Senate
                                                                                                                                                                                                                                                                              • • CBO Releases Updated Budget Projections for SGR Patch

                                                                                                                                                                                                                                                                                  Health Policy Report - April 1, 2014
                                                                                                                                                                                                                                                                                  • • The US Oncology Network Joins Community Oncology Alliance in Urging Congressional Leaders to Address Cancer Care Crisis
                                                                                                                                                                                                                                                                                  • • Congress Moves to Avert Medicare Physician Payment Cuts
                                                                                                                                                                                                                                                                                  • • New Analysis Shows Many 340B Hospitals Provide Minimal Charity Care
                                                                                                                                                                                                                                                                                  • • Obamacare Open Enrollment Period Closes

                                                                                                                                                                                                                                                                                      Health Policy Report - March 20, 2014
                                                                                                                                                                                                                                                                                      • • House Passes SGR Repeal with Delay of ACA Individual Mandate
                                                                                                                                                                                                                                                                                      • • Coalition for Patient Centered Imaging Urges Congress to Preserve Patient Access to Integrated Care
                                                                                                                                                                                                                                                                                      • • New Report Finds Overall Cancer Cases on the Rise
                                                                                                                                                                                                                                                                                      • • HHS Updates HIPAA Regulations
                                                                                                                                                                                                                                                                                      • • Colon Cancer Rates Drop by 30 Percent

                                                                                                                                                                                                                                                                                          Health Policy Report - March 6, 2014
                                                                                                                                                                                                                                                                                          • • Virginia Cancer Specialists Featured in Fox New Special Report
                                                                                                                                                                                                                                                                                          • • Op-Ed Highlights Importance of Rational Payments for Cancer Care
                                                                                                                                                                                                                                                                                          • • President Obama Releases 2015 Budget Proposal
                                                                                                                                                                                                                                                                                          • • CBO Releases Score for SGR Bill
                                                                                                                                                                                                                                                                                          • • Quality Data Added to CMS’ Physician Compare Website
                                                                                                                                                                                                                                                                                          • • World Health Organization: Cancer Cases on the Rise

                                                                                                                                                                                                                                                                                              Health Policy Report - February 20, 2014
                                                                                                                                                                                                                                                                                              • • The US Oncology Network’s Dr. Barry Brooks Calls for Equalization of Medicare Payments in The Hill
                                                                                                                                                                                                                                                                                              • • OIG Releases Report on 340B Drug Discount Program
                                                                                                                                                                                                                                                                                              • • Congress Votes to Extend Sequestration
                                                                                                                                                                                                                                                                                              • • Lancet Oncology Paper Calls on Oncology Community to Recognize Costs, Limitations of Cancer Treatments
                                                                                                                                                                                                                                                                                              • • Insurance Exchange Enrollment Climbs to 3.3 Million
                                                                                                                                                                                                                                                                                              • • CBO Report Finds Slower Medicare Spending Growth

                                                                                                                                                                                                                                                                                                  Health Policy Report - February 6, 2014
                                                                                                                                                                                                                                                                                                  • • Lawmakers Reach SGR Deal with Five Years of 0.5 Percent Payment Hikes
                                                                                                                                                                                                                                                                                                  • • President Obama Delivers State of the Union Address
                                                                                                                                                                                                                                                                                                  • • Congressman Henry Waxman Announces Retirement
                                                                                                                                                                                                                                                                                                  • • CMS Report Finds ACOs Are Lowering Spending Growth
                                                                                                                                                                                                                                                                                                  • • CMMI Technical Expert Panel for Oncology Examines Alternative Payment Models
                                                                                                                                                                                                                                                                                                  • • COA and ASCO Release Principles for Payment System Reform

                                                                                                                                                                                                                                                                                                      Health Policy Report - January 23, 2014
                                                                                                                                                                                                                                                                                                      • • MedPAC Recommends Aligning Payments Across Care Settings
                                                                                                                                                                                                                                                                                                      • • CMS Announces Release of Physician Payment Data
                                                                                                                                                                                                                                                                                                      • • Congress Approves $1.1 Trillion Spending Bill
                                                                                                                                                                                                                                                                                                      • • New Study: IMRT Improved Survival Rates in Head and Neck Cancer Patients

                                                                                                                                                                                                                                                                                                          Health Policy Report - January 7, 2014
                                                                                                                                                                                                                                                                                                          • • Congress Returns to Washington; Budget Deal Needed Before January 16 Deadline
                                                                                                                                                                                                                                                                                                          • • Senate Finance and Ways and Means Committees Mark Up Permanent SGR Replacement Bill
                                                                                                                                                                                                                                                                                                          • • Obamacare Enrollment Swells in December
                                                                                                                                                                                                                                                                                                          • • New Obama Administration Report Claims Slow Healthcare Spending Growth
                                                                                                                                                                                                                                                                                                          • • Final USPSTF Screening Recommendations for Lung Cancer Released

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