Legislative Updates

Janssen CarePathGeneral Resources

Posted January 13, 2020

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...

2018 ASCO Advocacy Champions

Posted October 3, 2018

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...

FMA 2018 Legislative Report

Posted March 19, 2018

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...

CMS Releases Proposed Medicare Payment Rules for 2018

Posted July 20, 2017

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...

Florida Uniform Prior Authorization Form

Posted June 7, 2017

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

Legislative Action: Support the Roe regulatory relief letter to HHS.

Posted May 9, 2017

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. ...

FLASCO supports Restoration of Department of Health Funding for the Mary Brogan Breast & Cervical Cancer Early Detection Program

Posted April 19, 2017

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...

Support SB 528/ SB 530 by Senator Steube – FAIL FIRST/STEP THERAPY

Posted February 20, 2017

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...

Funding for Mary Brogan Breast and Cervical Cancer Early Detection Program

Posted February 20, 2017

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....

House Passes Medical Cures Bill – 21st Century Cures Act

Posted December 1, 2016

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...

Urge Your Lawmaker to VOte “Yes” On The 21st Century Cures Act

Posted November 29, 2016

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

Posted November 17, 2016

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...

New Health Affairs Report on Physician Consolidation Shows Rapid Movement from Small to Large Group Practices

Posted September 22, 2016

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...

Physician Advocate Institute: Hospital Ownership of Physician Practices Increases Nearly 90 Percent in Three Years

Posted September 22, 2016

  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...

MedPAC Examines Physician Affiliation and Practice Size

Posted September 22, 2016

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 Supports Local Coverage Determination Clarification Act

Posted September 22, 2016

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...

Alliance for Site Neutral Payment Reform Launches New Website

Posted September 22, 2016

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...

CMS Proposes New Medicare Physician Payment System (Source: US Oncology)

Posted May 5, 2016

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...

Don’t forget: Contact Congress and ask them to Stop the Cancer Experiment!

Posted April 25, 2016

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...

300+ National & State Organizations Ask Congress: Stop the CMS Drug Payment Proposal!

Posted March 17, 2016

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...