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

COA 2022 PBM Dirty Tricks Exposé Report

There is growing awareness of the problems and pitfalls with Pharmacy Benefit Managers (PBMs) in the United States health care system. Contracted by plan sponsors (including government programs, self-insured employers, and insurance companies) to negotiate on their behalf with pharmaceutical companies, these “middlemen” corporations have quietly become an unavoidable part of our nation’s health care system. 

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

The Promise of Biosimilars in Cancer Care and Reality of the U.S. Market

Biological products, or biologic drugs, have transformed the way patients with many diseases, including cancer, are treated. Some examples of biologics include hormones, blood products, cytokines, growth factors, vaccines, gene and cellular products, fusion proteins, insulin, interferon, and monoclonal antibody products.

By |2024-03-05T09:44:25-05:00March 3rd, 2023|Research & Publications|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