01/24/2018

Congress Urged to Fix Rule Distorting Quality Payment Program Adjustments

ASCO and 46 State and Regional Affiliates are among 109 healthcare groups urging Congress to address a rule that would penalize oncology and other medical specialties for their use of Medicare Part B drugs. In letters to Congressional committee leadership in both the House and Senate, the organizations urged lawmakers to pass a technical correction ensuring that payment adjustments under the Quality Payment Program (QPP) are not applied to Part B reimbursement. The letters urge swift Congressional action, as changes to QPP that began on January 1 could negatively impact patient access critical treatments. 

In November 2017, the Centers for Medicare & Medicaid Services (CMS) finalized its plan to include Part B reimbursement in the Merit-based Incentive Payment System (MIPS) payment adjustment, under QPP. In ASCO’s view, this change distorts the magnitude of MIPS penalties and bonuses far beyond what Congress intended when drafting the Medicare Access and CHIP Reauthorization Act (MACRA), which established QPP. ASCO’s data show that the median financial penalty for oncology practices under the provision would range from 13.7% - 22.9%, well beyond the Congress-envisioned 4% penalty, and leave some oncology practices with no choice but to close their doors.

ASCO and its fellow signatories stand ready to work with Congress and CMS on improving access to care for Medicare beneficiaries and ensuring the successful implementation of MACRA.

Contact your lawmakers and urge them to address the MIPS adjustment to Part B drugs using the ACT Network.