On February 6, a rapid recommendation update on Capivasertib-Fulvestrant was published. The rapid update has implications for two guidelines: Endocrine Treatment and Targeted Therapy for HR-Positive, HER2-Negative Metastatic Breast Cancers and Biomarkers for Systemic Therapy in Metastatic Breast Cancer.
Congress passed a six-part spending bill that funds several government agencies, including the FDA, through Sept. 30, 2024—the end of the fiscal year. The legislative package also contains a 1.68% increase to the Medicare physician reimbursement rate until Dec. 31, 2024. The increase partially reduces the 3.37% reimbursement cut that went into effect on January…
Healthcare workforce and innovation were front and center during the 2024 Legislative Session, which concluded on Friday, March 8. The FMA was an active participant in shaping the future of Florida’s healthcare landscape, which can be seen through the pro-physician victories outlined in our end-of-session report.
The Florida legislature passed a bill late Tuesday that expands patient access to biomarker testing, a key tool used by physicians to identify the most effective treatment of cancer and other diseases. In the case of a cancer diagnosis, biomarker testing allows doctors to develop a personalized treatment plan so patients may not have to…
On February 11, a federal judge dismissed a drug industry trade group’s legal challenge to halt Medicare drug price negotiations, ruling that it lacked standing. The complaint was filed by the Pharmaceutical Research and Manufacturers of America (PhRMA), the Global Colon Cancer Association (GCCA), and the National Infusion Center Association (NICA) in June of last…
February 14, 2024 marked day 30 of the 60-day Florida Legislative Session, and the FMA remains hard at work to help physicians practice medicine. This midpoint report by FMA Assistant General Counsel Mary Thomas, Esq., summarizes some of the most notable bills that could affect you and your patients, where each one stands in the…
In a big win for physicians and patients, the Centers for Medicare & Medicaid Services recently released a final prior authorization and interoperability rule that makes significant improvements to the prior authorization process — most importantly, shortening the timeframes for payors to make decisions on such requests. Set to take effect in 2026, these changes…
On Thursday evening, Congress passed another short-term spending bill, funding the federal government into early March. Unfortunately, the bill only extended healthcare-related policies that were included in the previous funding bill and does not include any new healthcare policies, such as an increase in the Medicare Physician Fee Schedule. The previous spending bill funded a…
House Speaker Paul Renner and Senate President Kathleen Passidomo say they are co-signing on each other’s health care priorities, including Passidomo’s Live Healthy package. The $900 million proposal includes two bills (SB 7016, SB 7018) designed to increase the number of doctors, while encouraging technological innovation.
Time is running out for Congress to eliminate a 3.37% Medicare physician payment cut by passing H.R. 6683, the “Preserving Seniors’ Access to Physicians Act.” Please urge your Congress members to support including H.R. 6683 in the 2024 appropriations package by submitting this form letter. Further cuts in Medicare physician pay would undermine access to…
On Monday, Oct. 29, President Joe Biden signed an executive order prioritizing the establishment of new safety, security, and fairness standards for artificial intelligence (AI), especially within the domain of healthcare. This directive mandates that developers of AI systems, particularly those bearing potential risks to public health and safety, must share their training data with…
As you well know, the flawed Medicare physician payment system is in desperate need of fixing and unfortunately things are about to get worse. Recently CMS announced final plans for payment schedules for physicians and spoiler alert, it’s not good! CMS approved a 3.4% reduction in Medicare’s physician payments for 2024. That means if Congress…
https://www.janssencarepath.com/hcp/general-resources Access support to help navigate payer processes Know Your State Interactive Tool — Provides information on affordability options for your patients at the state level. Supporting Appropriate Payer Coverage Decisions Brochure — Helps you understand the information that payers may require for your patient’s coverage of medically necessary drug therapies. Prior Authorization Considerations Checklist — Presents general information…
At the 2018 ASCO Advocacy Summit this month, members of various categories of its 2018 Advocacy Champions were announced President’s Circle – ASCO advocates who regularly participate in more than one of these advocacy activities: virtual advocacy (sending ACT Network emails); in person advocacy (conducting visits on Capitol Hill, with agency officials or at home…
The 2018 Florida Legislative Session concluded on Sunday, March 11, with only 200 bills passed by both chambers and sent to Gov. Rick Scott. The FMA succeeded in getting Direct Primary Care legislation passed, and we secured important changes in the opioid bill for the benefit of physicians and their patients who suffer from acute…
The Centers for Medicare and Medicaid Services (CMS) has issued two proposed rules to update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) and the Hospital Outpatient Prospective Payment System (OPPS). CMS will be accepting comments on these rules until September 11, 2017. The final rules are expected…
The Florida standardized PA goes into effect 7/11 and payers have 6 months to transition. Florida Rule for Uniform PA Form Florida Uniform PA Form Instructions Florida Uniform PA Form
BACKGROUND: FLASCO is concerned about the tremendous burden oncologists face in juggling the requirements of multiple Medicare quality improvement programs, often at the expense of time spent on patient care. The historic passage of the Medicare Access and CHIP Reauthorization Act (MACRA) would ease both the administrative and financial burdens of existing quality improvement programs. …
Mary Brogran Breast & Cervical Cancer Early Detection Program (Sec. 381.93, F.S.) Florida Department of Health Current Year State Funding (FY 2016-17) – $2,100,00 ($300,000 recurring; $1,800,000 nonrecurring) House Position (Line Item 447) – $325,000 recurring Senate Position (Line Item 447) – $350,000 recurring Request – $2,100,00 in total funding Program Description – The Mary…
While health insurance utilization management (restrictions on access) procedures such as fail first/step therapy may be appropriate measures to control costs, they have also been over-utilized under the cloak of confusion surrounding health care and to the detriment of numerous patients across Florida. Contact your legislator today to let them know, ultimately, healthcare professionals, not…
The Mary Brogan Breast and Cervical Cancer Early Detection Program provides lifesaving cancer screenings for medically underserved women between the ages of 50 and 64 who have incomes below 200% of the federal poverty level. For 2017, ACS CAN asks that the state fund the program at a level equal to one-half of the U.S….
The House on Wednesday passed a medical innovation bill aimed at curing diseases, with the measure securing bipartisan support after months of negotiations. The legislation, known as the 21st Century Cures Act, passed 392-26. It seeks to speed up the Food and Drug Administration’s approval of new drugs while investing new money in medical research. The package…
CURRENT STATUS: The House and Senate have reached a bipartisan, bicameral compromise on the 21stCentury Cures Act. The legislation includes nearly all of FLASCO’s supported provisions and is the culmination of over two years of work. The last chance for this legislation to pass during this Congress, and according to some, at all, is over…
MedPAC Holds Meeting on Provider Consolidation On November 3, the Medicare Payment Advisory Committee (MedPAC) hosted a meeting on provider consolidation and its effect on the Medicare system. The discussion primarily focused on the trends towards horizontal and vertical integration among providers – essentially hospitals buying physician practices and then billing the services through their…
A recent report in Health Affairs titled “Physician Consolidation: Rapid Movement from Small to Large Group Practices, 2013–15” identified an accelerating trend of physicians moving from small to large group practices, with more pronounced effects among primary care physicians. The authors used information from Medicare’s Physician Compare dataset to examine changes in the makeup of…
According to a new study by the Physician Advocate Institute (PAI) and Avalere Health, the number of physician practices owned by hospitals or health systems rose 86 percent between 2012 and 2015. To reach this conclusion, Avalere examined a database of payment information maintained by SK&A, a health care consultancy, to pinpoint practice ownership…
On September 8, the Medicare Payment Advisory Commission (MedPAC) met to discuss the increase in physician practices that have been purchased by hospitals or health systems, including how increases in physician practice size impact Medicare payment policy. MedPAC reviewed a private-sector database of physician information and practice characteristics, and merged it with Medicare claims to…
The US Oncology Network sent a letter to Congresswoman Lynn Jenkins (R-KS) and Congressman Ron Kind (D-WI) expressing support for the Local Coverage Determination Clarification Act (H.R. 5721), legislation that changes the process Medicare Administrative Contractors (MACs) use to make local coverage decisions that can limit or deny patients’ access to care. Specifically, the bill…
On September 12, The Alliance for Site Neutral Payment Reform launched a new website (www.siteneutral.org) to better educate lawmakers, industry stakeholders, and the public about the many benefits of advancing site neutral payment reforms across America’s healthcare delivery system. The website houses research and other resources on the value of payment parity across sites of…
On April 27, the Centers for Medicare and Medicaid Services released much-anticipated proposed regulations that will govern implementation of the new Medicare physician payment system that replaces the sustainable growth rate (SGR) formula repealed by Congress last year. The new system offers physicians two pathways for Medicare payment beginning in 2019: the Merit-Based Incentive Payment…
The next two weeks are critical to stopping the misguided Medicare experiment on cancer care! Make your voice heard – call, email, Tweet, and send Facebook messages to your elected officials asking them to Stop the Medicare Experiment on Cancer Care. COA has set up the CancerExperiment.com website for easy advocacy action. Share the website…
This morning an unprecedented 313 national and state health care organizations, including FLASCO sent a letter to Congress expressing strong concern with the proposed CMS Medicare Part B Drug Payment Model. The organizations request that Congress ask CMS to withdraw the proposed rule. Click here to read the latest letter. The letter notes that the organizations believe…
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