Community Oncology Alliance Calls on Express Scripts to Fix Underwater Reimbursement to Oncology Pharmacy Providers

On October 26, 2023, the Health Resources and Services Administration (HRSA) issued a Notice to “inform and remind” 340B Program covered entities that to be considered eligible for the 340B program, an off-site outpatient facility of a covered entity (commonly referred to as a “child site”) must be reimbursable on the covered entity’s most recently filed Medicare cost report (MCR) and listed in the Office of Pharmacy Affairs Information System (OPAIS) as a child site of the covered entity.

By |2024-03-05T09:43:07-05:00February 23rd, 2024|Latest News, Comment Letters, Featured|0 Comments

COA Comments to CMS on Streamlining the Prior Authorization Process

On behalf of the Board of Directors of the Community Oncology Alliance (“COA”), we are submitting this comment letter regarding a proposed rule by the Centers for Medicare & Medicaid Services (“CMS”) on streamlining the prior authorization process. In this document, we refer to this prior authorization proposed rule (CMS-0057-P) as the “Proposed Rule.”

By |2023-12-15T10:32:43-05:00March 21st, 2023|Comment Letters|0 Comments

Letter to Defense Health Agency on TRICARE PBM Concerns

In its role as the PBM for the TRICARE program, in late July 2022, Express Scripts sent providers across the nation a new TRICARE contract/network agreement for contract year 2023. 

By |2024-03-05T09:44:40-05:00March 3rd, 2023|Comment Letters, Research & Publications|0 Comments

COA Comments to Congress on MACRA RFI

COMMUNITY ONCOLOGY ALLIANCE Innovating and Advocating for Community Cancer Care 1225 New York Ave. NW, Suite 600 Washington, DC 20005 (202) 729-8147 | communityoncology.org October 31, 2022 Submitted via email to: macra.rfi@mail.house.gov The Honorable Ami Bera The Honorable Larry Bucshon The Honorable Kim Schrier

By |2022-11-01T14:53:15-04:00November 1st, 2022|Comment Letters|0 Comments

Letter to Defense Health Agency on TRICARE PBM Concerns

On behalf of the Community Oncology Alliance (“COA”), we are submitting our concerns regarding the Enhancing Oncology Model (“EOM”) to the leadership at the Centers for Medicare & Medicaid Services (“CMS”) and Center for Medicare and Medicaid Innovation (“CMMI”). 

By |2023-03-03T02:01:57-05:00October 19th, 2022|Comment Letters|0 Comments

Senate Letter to FTC on Status of PBM Investigation

October 6, 2022 The Honorable Lina Khan Chairwoman Federal Trade Commissioner 600 Pennsylvania Avenue, N.W. Washington, D.C. 20580 Dear Chair Khan, We support the Federal Trade Commission’s (FTC) issuance of a Section 6(b) order and conducting a study of pharmacy benefits managers’ (PBM) business practices. In your recent participation before the Subcommittee on Competition

By |2022-12-27T10:27:12-05:00October 7th, 2022|Comment Letters|0 Comments

COA Formal Comments to CMS on Enhancing Oncology Model Concerns

On behalf of the Community Oncology Alliance (“COA”), we are submitting our concerns regarding the Enhancing Oncology Model (“EOM”) to the leadership at the Centers for Medicare & Medicaid Services (“CMS”) and Center for Medicare and Medicaid Innovation (“CMMI”). 

By |2022-09-14T10:32:09-04:00September 14th, 2022|Comment Letters|0 Comments

Congressional Letter to UnitedHealthcare on CINV Step Therapy

We are writing to express our concerns with your instituted step-edit policy for antiemetic drugs used to combat chemotherapy-induced nausea and vomiting, or CINV. We have been consistently hearing about aggressive step therapy schemes that are putting our constituents suffering from cancer at an increased risk of experiencing horrific side effects, by first requiring oncologists to prescribe CINV drugs that they do not deem to be appropriate for certain treatment regimens.

By |2022-09-16T11:16:03-04:00September 13th, 2022|Comment Letters|0 Comments

Letter to CMS on the CY 2023 Hospital Outpatient Prospective Payment System (HOPPS) Proposed Rule

On behalf of the Board of Directors of the Community Oncology Alliance (COA), we are submitting this comment letter regarding the CY 2023 Medicare Physician Fee Schedule (“MPFS”), CMS-1770-P, Proposed Rule (“Proposed Rule”). As you know, COA is an organization dedicated to advocating for the complex care and access needs of patients with cancer and the community oncology practices that serve them. COA is the only nonprofit organization in the United States dedicated solely to independent community oncology practices, which serve the majority of Americans receiving treatment for cancer. Since its grassroots founding close to 20 years ago, COA’s mission has been to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities where they live and work, regardless of their racial, ethnic, demographic, or socioeconomic status.

By |2022-09-13T11:13:29-04:00September 13th, 2022|Comment Letters|0 Comments

COA Formal Comments on 2023 Physician Fee Schedule

On behalf of the Board of Directors of the Community Oncology Alliance (COA), we are submitting this comment letter regarding the CY 2023 Medicare Physician Fee Schedule (“MPFS”), CMS-1770-P, Proposed Rule (“Proposed Rule”). As you know, COA is an organization dedicated to advocating for the complex care and access needs of patients with cancer and the community oncology practices that serve them. COA is the only nonprofit organization in the United States dedicated solely to independent community oncology practices, which serve the majority of Americans receiving treatment for cancer. Since its grassroots founding close to 20 years ago, COA’s mission has been to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities where they live and work, regardless of their racial, ethnic, demographic, or socioeconomic status.

By |2022-09-01T13:22:38-04:00August 31st, 2022|Comment Letters|0 Comments