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Access, Payment & Reimbursement Reform

ACCC is committed to ensuring that cancer patients have access to the entire continuum of quality cancer care, including access to the most appropriate cancer therapies.

Virtual Oncology Reimbursement Meeting

On Thursday, December 12, 2024, ACCC held a virtual Oncology Reimbursement Meeting. Teri Bedard, BA, RT(R)(T)(ARRT), CPC, Executive Director of Client & Corporate Resources at Revenue Cycle Coding Strategies, discussed the recent Medicare final rules to be implemented in 2025 and how they pertain to oncology services and providers. In addition, Nicole Tapay, ACCC’s Director of Cancer Care Delivery and Health Policy, provided a federal policy update.

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Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services

As of January 1, 2024, the Centers for Medicare and Medicaid Services introduced new codes so that Medicare could reimburse for patient navigation services. To address challenges of implementation, the Association of Cancer Care Centers has a 4-part webinar series, Implementing the New CMS Reimbursement Billing Codes for Patient Navigation Services, hosted by Teri Bedard of Revenue Cycle Coding Strategies.

On-Demand Webinar

The New CMS Navigation Reimbursement Billing Codes: A 101

The 2024 Physician Fee Schedule included 7 new codes specific to care management. This webinar reviews how these differ from the care management codes available from the American Medical Association, common questions, and challenges for implementing these new codes.
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On-Demand Webinar

AMA CPT® Coding Update for Oncology Navigation Services and The Cancer Moonshot

The American Medical Association (AMA) released a coding update for oncology navigation services in alignment with The Cancer Moonshot program. Featuring discussion on the updates and guidelines from the AMA and review of the components of the AMA’s codes, how these differ from the codes from CMS, and challenges for providers.
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On-Demand Webinar

Principal Illness Navigation (PIN) Services Documentation, Coding, and Billing

The 2024 Physician Fee Schedule includes four new codes specific to Principal Illness Navigation–Peer Support. With these new codes, providers will be able to bill for the services of navigators, social workers, and support personnel. This webinar goes into a deep dive, reviewing components of the new codes, answering common questions, and addressing challenges for providers.
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On-Demand Webinar

CHI & SDOH Risk Assessment Documentation, Coding, and Billing for Oncology Providers and Administrators & Series Wrap-up

The 2024 Physician Fee Schedule includes seven new codes specific to CHI services, SDOH Risk Assessment, and Principal Illness Navigation–Peer Support. With these new codes, providers can bill for the services of navigators, social workers, and support personnel. This final installment reviews the components of these new codes, common questions, and challenges for providers.
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  • ACCC Submits Letters to the Centers for Medicare and Medicaid Services (CMS) on PFS and OPPS Regulations
    September 23, 2024

    On September 9, 2024, ACCC submitted comment letters to the Centers for Medicare and Medicaid Services (CMS) on the proposed physician fee schedule (PFS) and hospital outpatient prospective payment system (OPPS) regulations. Among other topics, ACCC asked CMS to remain open to discuss any issues that arise with implementation of the principal illness navigation (PIN) codes and other codes to reimburse for patient navigation services. ACCC also supported the proposed add-on payment for high-cost drugs delivered in the hospital outpatient departments of Indian Health Service (IHS) hospitals and tribal hospitals.
    PFS Letter OPPS Letter 

ACCC Shares Resources to Address National Anti-Cancer Drug Shortages

National shortages of anti-cancer drugs, including cisplatin, carboplatin, and methotrexate, reached an all-time high during the first quarter of 2023. The Association of Cancer Care Centers (ACCC) recognizes the significant stress and concern caused by the scarcity of life-saving drugs for cancer patients nation-wide.

Dive in to learn about the advocacy efforts ACCC has championed to help patients and providers navigate cancer care under the current conditions.

Critical Conversations: National Drug Shortages and Empowering Oncology Pharmacists

 

Issues related to the oncology drug shortage prompted seven oncology care experts to gather for a roundtable discussion, Critical Conversation: National Drug Shortages and Empowering Oncology Pharmacists. ACCC has shared a recording and a transcript of their conversation.
Download the Q&A Transcript

From the ACCCBuzz Blog

  • Discussions that Matter: Managing Drug Shortages and Empowering Oncology Pharmacists
    July 18, 2023
    In the face of an unprecedented drug shortage, HOPA partnered with ACCC and AVAHO to lead a virtual round table discussing best practices the multidisciplinary cancer care team can use to mitigate its effects.
  • Discussions that Matter: A Look at the Current Drug Shortage
    July 10, 2023
    In the face of an unprecedented drug shortage, Hematology/Oncology Pharmacy Association (HOPA) partnered with the Association of Community Cancer Centers (ACCC) and Association of VA Hematology/Oncology (AVAHO) to lead a virtual round table aimed at developing practical strategies healthcare organizations around the country can adopt.

Our Partners

hopa-200x80Association of VA Hematology/Oncology (AVAHO).

In partnership with Hematology/Oncology Pharmacy Association (HOPA) and Association of VA Hematology/Oncology (AVAHO).

Enhancing Oncology Model (EOM) Resources

  • The Innovation Center Releases EOM Factsheets

    Last year, the Center for Medicare & Medicaid Innovation (the Innovation Center) announced the  Enhancing Oncology Model (EOM)—the Oncology Care Model's successor. Now, the Innovation Center has released two resources to help EOM stakeholders understand the model's health equity strategy and new enhanced services requirement. 

    The application period for the EOM closed on October 10, 2022, and the Centers for Medicare & Medicaid Services is in the process of reviewing submitted applications in advance of the model launch on July 1, 2023.

    For more information on the EOM, visit its dedicated its dedicated website, email its support team, or call 1.888.734.6433, option 3.

     



  • CMS Delays Radiation Oncology Model For Further Rulemaking

    On August 29, 2022, the Centers for Medicare & Medicaid Services (CMS) published a final rule (CMS-5527-F2) that finalized delaying the Radiation Oncology Model start date until a date is determined through future rulemaking.

    For more information, visit the Radiation Oncology Model website.

    Posted 8/30/2022



  • CMS Announces the Enhancing Oncology Model

    On June 27, 2022, the Biden Administration, through the Department of Health and Human Services and Centers for Medicare & Medicaid Services (CMS), announced a new model to improve cancer care for Medicare patients: the Enhancing Oncology Model (EOM). This model is the successor to the Oncology Care Model (OCM).

    The EOM—designed by the Center for Medicare and Medicaid Innovation—will tackle the health inequities and meet patients' throughout the cancer care continuum, with an emphasis on person-centered care and better patient outcomes. The model will run from July 2023 through June 2028, and its participants will include oncology practices that treat people with Medicare undergoing chemotherapy for breast cancer, chronic leukemia, lung cancer, lymphoma, multiple myeloma, prostate cancer, and small intestine/colorectal cancer. 

    For additional information regarding the EOM, visit the CMS website. Then read ACCC's statement.

    Posted 6/29/2022



Archived Documents

Archive of ACCC Comment Letters on CMS Physician Fee Schedule:

Archive of ACCC Comment Letters to CMS on Recent OPPS Proposed Rules: