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The Background: NCOA and ASCO are committed to supporting policies that reduce cost while preserving quality of cancer care; however, it is critical that such policies be developed and implemented in a way that does not undermine patient access. Payer utilization management approaches like prior authorization are of particular concern because they represent greater likelihood of raising barriers to appropriate care for individuals with cancer. The Association for Clinical Oncology (ASCO) and the North Carolina Oncology Association (NCOA) support efforts to streamline the prior authorization process so that patients receive timely access to care and physicians can spend more time treating their patients.

Why it Matters: NCOA and ASCO support the NC Cares First Act (HB 434), prior authorization reform legislation under consideration in the North Carolina House Health Committee that would alleviate administrative burden on physicians, accommodate the special needs of patients with cancer, and improve transparency.

HB 434 requires insurers to update their clinical review criteria at least annually and to use recognized guidelines. The bill also requires insurers to consult with the patient\u2019s physician before denying medically necessary care; mandates insurers make timely decisions, especially when treatment is urgent; and limits retrospective denials, ensuring that services already provided cannot be retrospectively denied without justified reasons.

The bill will be heard by the House Health Committee during the week of March 31.

The Ask: Join NCOA and ASCO in urging members of the House Health Committee to support HB 434 to ensure patients with cancer in North Carolina access to care in a timely manner.

Take action today!

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The Background: The House of Representatives recently passed a budget resolution that would require significant reductions in federal spending. There is speculation that to meet those savings targets, Congress may look to cut from the Medicaid program. While some lawmakers suggest targeting \u201cwaste, fraud, and abuse\u201d in the Medicaid program, it is unclear what would be targeted. More than 70 million Americans rely on Medicaid for access to health care, including many patients with cancer. It is important that Congress safeguard the program for patients with cancer.

Why it Matters: Medicaid serves as a critical lifeline, particularly for vulnerable populations like low-income families and children facing cancer. For these children, Medicaid often provides the only means of accessing life-saving treatments and specialized care. Therefore, any reduction in Medicaid funding or the imposition of work requirements poses a threat to patient care. Due to the demands of cancer treatment, satisfying work requirements may be problematic for patients with cancer and their caregivers, who often need to stop working entirely\u2014or dramatically reduce the number of hours worked\u2014making such requirements an insurmountable barrier to care.\u00a0

The Ask: Ask your lawmakers to safeguard Medicaid by opposing any legislation that would reduce federal support for the program, restrict access, or create barriers for cancer patients to receive care.

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Background:\u00a0

The Indiana Oncology Society (IOS) and the Association for Clinical Oncology (ASCO) have concerns with SB 2, a bill that would institute work requirements for Medicaid beneficiaries. IOS and ASCO believe work requirements could have significant negative consequences for patients with cancer.\u00a0\u00a0

Please contact your state lawmakers today and urge them to add a clear exemption to the work requirement for patients with cancer who are in active treatment and for the exemption to last at least one full year after their final treatment.\u00a0

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The Background: The Association for Clinical Oncology (ASCO) and the Iowa Oncology Society (IOS) strongly oppose harmful practices utilized by pharmacy benefit managers (PBM) in cancer care, such as co-pay accumulator programs and patient steering to payer-owned or affiliated pharmacies. Co-pay accumulators are programs within an insurance plan whereby manufacturer\u2019s co-pay assistance does not count toward the patient\u2019s deductible and out-of-pocket maximum.\u00a0Co-pay accumulator programs target specialty drugs for which manufacturers often provide co-pay assistance. Patients with co-pay accumulator programs will likely experience significantly increased out-of-pocket costs at the end of their plan year and may be unable to afford necessary medication. PBMs have also increasingly steered patients away from receiving their medication from their dispensing physician to PBM-owned or affiliated pharmacies instead.

Why it Matters: ASCO and IOS support House File 852 and Senate File 383, legislation that bans co-pay accumulators and prevents PBMs from steering patients to payer-owned or affiliated pharmacies. Both bills recently passed out of their respective Committees and can now be brought to the floor for passage.

The Ask: Join ASCO and IOS in urging all Representatives and Senators to support HF 852 and SF 383 when it reaches the floor and help protect patients with cancer in Iowa from harmful PBM practices.

Take action today!

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Why it Matters: ASCO and IOS support House File 852 and Senate File 383, legislation that bans co-pay accumulators and prevents PBMs from steering patients to payer-owned or affiliated pharmacies. Both bills recently passed out of their respective Committees and can now be brought to the floor for passage.\u00a0

The Ask: Join ASCO and IOS in urging all Representatives and Senators to support HF 852 and SF 383 when it reaches the floor and help protect patients with cancer in Iowa from harmful PBM practices.

Take action today!

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Take action today!

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The Background: While the Association for Clinical Oncology (ASCO) and the Iowa Oncology Society (IOS) are committed to supporting policies that reduce cost while preserving quality of cancer care, it is critical that such policies do not undermine patient access. Payer utilization management approaches like prior authorization are of particular concern because they represent greater likelihood of raising barriers to appropriate care for individuals with cancer. IOS and ASCO support efforts to streamline the prior authorization process so that patients receive timely access to care and physicians can spend more time treating their patients.

Why it Matters: IOS and ASCO support SF 231, prior authorization reform legislation under consideration in the Iowa Senate. SF 231 would help ensure timely access to care by requiring insurers to respond to a prior authorization request within 48 hours if urgent or 10 calendar days if nonurgent. Additionally, the bill would create a pilot program to offer some providers an exemption from certain prior authorization requirements, allowing physicians to skip the burdensome prior authorization process.

The Iowa House unanimously passed HF 303, companion legislation to SF 231, on February 20. Ask your Senator to support SF 231 when it reaches the Senate floor.

The Ask: Join IOS and ASCO in urging all Senators to support SF 231 on the Senate floor and help ensure the timely delivery of care to Iowa patients with cancer.

Take action today!

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Test

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Call test

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Background: The Missouri Oncology Society (MOS) and the Association for Clinical Oncology\u202f(ASCO) have concerns with SB 79, a bill that would allow qualified membership organizations (such as the Farm Bureau) to offer their employees and beneficiaries health insurance not compliant with the Affordable Care Act\u2019s essential health benefits. Since these plans do not comply with ACA protections, patients with cancer are at risk for denial of coverage due to pre-existing condition limitations and often lack coverage for evidence-based cancer screenings. All Missourians should have access to comprehensive health insurance. The Senate Insurance and Banking Committee voted to pass the bill on February 4.

The Ask: Join MOS and ASCO in urging Senators to oppose SB 79 and help ensure patients with cancer in Missouri have access to comprehensive health insurance.\u00a0

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The Background: On January 1, a 2.8% cut to Medicare physician reimbursement went into effect, on top of the 1.68% decrease in 2024. The existing Medicare physician payment system is unsustainable, and ASCO is calling on Congress to reform it.

Physicians are the only providers who do not automatically receive an annual inflationary update from Medicare. Year after year, reimbursement for physicians falls drastically below inflationary rates, resulting in cuts to reimbursement for services.
Budget neutrality requirements in the Medicare system limit the allocation of funds for essential cancer care services and can restrict the use of the newest and innovative treatments.
The Merit-Based Incentive Payment System (MIPS) places increased administrative burdens on providers and take time away from critical patient care.
The lack of incentives and financial stability hinder the broader transition to value-based care models.

The current Medicare reimbursement system makes it difficult for practices to maintain a viable business, and thus, impacts patients\u2019 access to Why it Matters: Physician reimbursement has fallen behind inflationary rates by 33% since 2001. Along with the increased administrative burden placed on providers, the limitations on resources allocated for necessary care, and the lack of incentives to transition to value-based care models, only amplify the unsustainable Medicare physician payment system.

The Ask: Join ASCO in asking Congress to pass the Medicare Patient Access and Practice Stabilization Act, legislation that would effectively offset the 2.8% cut that took effect on January 1, and provide an update through 2025.This bill, introduced by Reps. Greg Murphy, M.D. (R-NC-3), Jimmy Panetta (D-CA-19), John Joyce, M.D. (R-PA-13), Raul Ruiz, M.D. (D-CA-25), Mariannette Miller-Meeks, M.D. (R-IA-1), Kim Schrier, M.D. (D-WA-8), Claudia Tenney (R-NY-24), Ami Bera, M.D. (D-CA-6), Carol Miller (R-WV-1), and Raja Krishnamoorthi (D-IL-8) is an important step in protecting patient access to care while providing Congress with additional time to address long term reforms.

ASCO is also asking Congress to pass the Preserving Patient Access to Accountable Care Act, introduced by Reps. Darin LaHood (R-IL-16), Suzan DelBene (D-WA-1), Neal Dunn, M.D. (R-FL-2), and Kim Schrier, M.D. (D-WA-8), which would extend the Advanced Alternative Payment Model (APM) incentive for one year at 3.53%.

Please ask your lawmakers to support Medicare providers and ensure patient access to necessary care.

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Background: As lawmakers prepare to gavel in on January 21 for the 2025 State Legislative Session, it is important SUMO positions itself as a strong voice on cancer-related issues. The key legislative priority this session is to pass and get the Governor to sign HB 52, the Health Insurance Modification Act, sponsored by Representative Candice Pierucci (R-Dist 49) which requires a health benefit plan to count all payments paid on behalf of an enrollee towards the enrollees\u2019 deductible.\u00a0Reach out to your state legislators today to encourage them to support this bill, and the legislature should pass this bill this session.\u00a0 Also, express that you can be a key resource for cancer care related issues as they work through the session. We have provided a draft email you can send to your State Senator and Representative.\u00a0

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The Background:\u202fEach year Congress must develop and pass appropriations bills to fund the government for the new fiscal year (FY) beginning October 1. In December 2024, Congress passed a Continuing Resolution (CR) to fund the government at FY 2024 levels through March 14, 2025. It\u2019s important that Congress pass a full FY 2025 funding bill to limit the impact of long-term flat funding on cancer research planning.\u00a0

The FY24 appropriations package, passed in March 2024, provided $47.1 billion for the National Institutes of Health (NIH), $7.2 billion for the National Cancer Institute (NCI), and $1.5 billion for the Advanced Research Projects Agency for Health (ARPA-H).

On February 7, 2025, the NIH announced a new policy to cap indirect costs for NIH grants at 15%. These cuts could halt or end clinical trials, shutter sophisticated medical labs across the country, force young researchers to reconsider or abandon academic research and jeopardize Americans\u2019 access to the latest and best medical advancements, including new cancer treatments, for years to come.
\u00a0
Lawmakers need to hear from you on the importance of robust funding, both for direct and indirect costs, for the NIH, NCI, and ARPA-H in FY 2025.\u00a0

The Ask:\u00a0For FY 2025, ASCO, along with the broader medical and cancer research communities, asks Congress to support sustainable, long-term funding for biomedical and cancer research. ASCO urges Congress to pass a FY 2025 spending bill that includes at least:

$51.3 billion for the NIH
$7.934 billion for the NCI
$1.5 billion dedicated for ARPA-H

Additionally, ASCO asks Congress to continue language within the appropriations bill to prohibit changes to NIH indirect cost reimbursements.

Why it Matters:\u00a0ASCO stands ready and eager to work with the NIH, NCI and the entire cancer community to end cancer as we know it, and our funding request for the NIH and NCI is the first step. This year, a difficult budget environment has added pressure on the appropriations process. It\u2019s vital that we continue to highlight the need for robust federal funding for cancer research.

Please take a moment to contact your lawmakers.

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The Background:\u202fEach year Congress must develop and pass appropriations bills to fund the government for the new fiscal year (FY) beginning October 1. In March 2025, Congress passed a Continuing Resolution (CR) to fund the government at FY 2024 levels through the rest of the FY 2025 fiscal year. Now Congress will turn its attention to FY 2026. It\u2019s important that Congress pass a full FY 2026 funding bill before October 1 to limit the impact of long-term flat funding on cancer research planning.\u00a0

On February 7, 2025, the NIH announced a new policy to cap indirect costs for NIH grants at 15%. These cuts could halt or end clinical trials, shutter sophisticated medical labs across the country, force young researchers to reconsider or abandon academic research and jeopardize Americans\u2019 access to the latest and best medical advancements, including new cancer treatments, for years to come.
\u00a0
Lawmakers need to hear from you on the importance of robust funding, both for direct and indirect costs, for the NIH, NCI, and ARPA-H in FY 2026.\u00a0

The Ask:\u00a0For FY 2026, ASCO, along with the broader medical and cancer research communities, asks Congress to support sustainable, long-term funding for biomedical and cancer research. ASCO urges Congress to pass a FY 2026 spending bill that includes at least:

$51.3 billion for the NIH
$7.934 billion for the NCI
$1.5 billion dedicated for ARPA-H

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The Background: \u00a0A 2022 survey of ASCO members found that nearly all participants report their patients have experienced harm due to prior authorization caused by:

Delays in treatment (96%)
Patients being forced onto a second-choice therapy (93%)
Denied therapy (87%)
Increased out-of-pocket costs (88%)

ASCO members and State Affiliates continue to rate prior authorization as a top concern.

The Ask: ASCO supports legislative measures that would streamline the prior authorization process within the Medicare Advantage program. Last Congress, the Improving Seniors\u2019 Timely Access to Care Act had 290 combined cosponsors \u2014 59 senators and 231 representatives.

Why it Matters: Prior authorization requirements, which often take weeks to secure approval, can lead to potentially irreversible disease progression. These requirements also place a significant administrative burden on clinicians and their staff, who spend hours each week securing approvals which, consequently, hinders their ability to spend that time with patients.

Regulatory Update: Two CMS final regulations - the Electronic Prior Authorization Final Rule and the 2024 Medicare Advantage and Part D Final Rule - \u00a0include many of the Medicare Advantage prior authorization improvements we\u2019ve been seeking. Unfortunately, several of the changes don\u2019t take effect until 2027, and notably do not incorporate drugs into the electronic prior authorization program. Legislation is still necessary to ensure a comprehensive solution is implemented to address prior authorization burdens on patients and providers.

Urge your lawmakers to enact legislation that will streamline prior authorization requirements in the Medicare Advantage program.

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What\u2019s Happening: The ongoing shortages of critical oncology drugs are impacting patients and their oncology care team. ASCO is engaging with congressional leaders on both sides of the aisle and in the House and Senate on proposals to mitigate drug shortages. The lack of predictability in the generic cancer drug supply chain can have severely negative impacts on patients with cancer, including disruptions or delays in treatment, potentially leading to irreversible disease progression. Both Congress and the Administration need to intervene to secure the pharmaceutical pipeline and address drug shortages.

Take Action on Drug Shortages

Lawmakers need to hear from you that drug shortages are a high priority that must be addressed this year.

Write to your lawmakers and urge them to work with their colleagues to protect patients by mitigating drug shortages. Tip: Share how drug shortages are impacting you and your patients by including a story in the letters to your lawmakers.
Engage in the conversation via social media and tweet at your lawmaker here.

Learn more about what ASCO is doing to address drug shortages.

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Physicians are the only providers who do not automatically receive an annual inflationary update from Medicare. Year after year, reimbursement for physicians falls drastically below inflationary rates, resulting in cuts to reimbursement for services.
Budget neutrality requirements in the Medicare system limit the allocation of funds for essential cancer care services and can restrict the use of the newest and innovative treatments.
The Merit-Based Incentive Payment System (MIPS) places increased administrative burdens on providers and take time away from critical patient care.
The lack of incentives and financial stability hinder the broader transition to value-based care models.

The current Medicare reimbursement system makes it difficult for practices to maintain a viable business, and thus, impacts patients\u2019 access to care.

Why it Matters: Physician reimbursement has fallen behind inflationary rates by 33% since 2001. Along with the increased administrative burden placed on providers, the limitations on resources allocated for necessary care, and the lack of incentives to transition to value-based care models, only amplify the unsustainable Medicare physician payment system.

The Ask: Join ASCO in asking Congress to pass the Medicare Patient Access and Practice Stabilization Act, legislation that would effectively offset the 2.8% cut that took effect on January 1, and provide an update through 2025.This bill, introduced by Reps. Greg Murphy, M.D. (R-NC-3), Jimmy Panetta (D-CA-19), John Joyce, M.D. (R-PA-13), Raul Ruiz, M.D. (D-CA-25), Mariannette Miller-Meeks, M.D. (R-IA-1), Kim Schrier, M.D. (D-WA-8), Claudia Tenney (R-NY-24), Ami Bera, M.D. (D-CA-6), Carol Miller (R-WV-1), and Raja Krishnamoorthi (D-IL-8) is an important step in protecting patient access to care while providing Congress with additional time to address long term reforms.

ASCO is also asking Congress to pass the Preserving Patient Access to Accountable Care Act, introduced by Reps. Darin LaHood (R-IL-16), Suzan DelBene (D-WA-1), Neal Dunn, M.D. (R-FL-2), and Kim Schrier, M.D. (D-WA-8), which would extend the Advanced Alternative Payment Model (APM) incentive for one year at 3.53%.

Please ask your lawmakers to support Medicare providers and ensure patient access to necessary care.

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The Background: The flexibilities granted by the Department of Health and Human Services (HHS) during the Public Health Emergency (PHE) allowed expanded use of telehealth for Medicare beneficiaries and providers. This expanded telehealth utilization has helped ensure patients with cancer have uninterrupted access to high-quality care. The increased use of telehealth, when appropriate, has also helped providers reach historically underserved populations, including rural populations and those that might find it prohibitive to take off work, find childcare, and arrange transportation for an in-person visit.

Why it Matters: While these flexibilities were extended through September 30, without additional Congressional action the restrictions will return in October. Congress must take action to make telehealth flexibilities permanent to ensure continued access for Medicare patients regardless of where they live.

The Ask: ASCO urges Congress to support legislation that will permanently extend telehealth flexibilities in Medicare.

Contact your lawmakers and urge them to support permanent extension of Medicare telehealth flexibilities.

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