Local and National Advocacy

"The risk of not getting involved is that the most expert voices will not be heard. And then, the policies we have to live with won’t reflect what we know is best for our patients." 


Clifford A. Hudis, MD, FACP, FASCO

ASCO Chief Executive Officer

2026 State Legislative Sessions - Key Dates

Maine

Session Start:
January 7, 2026

Session End:
April 15, 2026

New Hampshire

Session Start:
January 7, 2026

Session End:
June 30, 2026

Vermont

Session Start:
January 6, 2026

Likely Session End:
May 8, 2026

2026 State Legislative Tracker


(ASCO has transitioned its bill tracker to 2026, including all carry over bills. The tracker updates in real time and the link is available to both ASCO members and nonmembers. ASCO tags legislation relevant to cancer care—including prior authorization, pharmacy benefit managers (PBMs), step therapy, copay accumulators, fertility preservation, telemedicine, Medicaid expansion, and vaccines.


Legislative Status Update

Active moving in session
Enacted signed into law
Dead failed or died
Stalled no movement
Verify needs confirmation
Federal ongoing implementation
New Hampshire Session ends June 4, 2026
Peer-to-peer review at any stage of prior authorization; disclosure of reviewer credentials
In Conference Committee as of May 26 — final stage before potential passage. Read the ASCO/NNECOS joint letter of support.
Active
Insurance cost-sharing calculations
Status requires direct verification before June 4. Read the ASCO/NNECOS joint letter of support.
Verify
SB606
(was SB120-FN)
Insurance coverage for biomarker testing
SB120-FN was tabled in 2025; SB606 is the active 2026 vehicle — passed Senate, pending House committee.
Active
Safety and care requirements for clinician-administered drugs
Carried over from 2025; re-referred to committee — verify recent House action before June 4. Read the ASCO/NNECOS joint letter of support (April 2026).
Verify
Work requirements under the state Medicaid program
Active in 2026 session — amendments to protect cancer patients still needed. Read the ASCO/NNECOS joint letter (January 2026) and call your representatives.
Active
Short-term, limited duration health insurance policies
Introduced April 2026; hearing held. Read the ASCO/NNECOS joint letter (April 2026) expressing concerns.
Active
HR1
Public Law No. 119-21 — federal Medicaid/coverage changes
Already enacted federally; advocacy focused on NH implementation. Read the ASCO/NNECOS joint letter.
Federal
Maine 132nd Legislature adjourned April 29, 2026
Insurance coverage for biomarker testing
Failed April 2026. NNECOS signed on in support. See the Maine Biomarker Coalition for future efforts.
Dead
Coverage for step therapy for advanced metastatic cancer
Signed into law; effective September 2025. Enforced for new insurance policies from January 2026. Read the ASCO/NNECOS joint letter of support.
Enacted
Prior authorization requirements for chronic conditions and long-term care
Passed both chambers but died on adjournment April 29, 2026 — held on appropriations table unfunded. Read the ASCO/NNECOS joint letter of support.
Dead
HR1
Public Law No. 119-21 — federal Medicaid/coverage changes
Already enacted federally; advocacy focused on Maine implementation. Read the ASCO/NNECOS joint letter.
Federal
Vermont Session ongoing — planned May 8 end date passed without adjournment; final days expected
Health insurance and Medicaid coverage for fertility care and preservation
Referred to House Health Care Committee February 2025; no committee meetings or votes recorded since — effectively stalled. Read the ASCO/NNECOS joint letter of support.
Stalled
HR1
Public Law No. 119-21 — federal Medicaid/coverage changes
Already enacted federally; advocacy focused on Vermont implementation. Read the ASCO/NNECOS joint letter.
Federal


Federal Legislation

Federal Legislative Tracker — NNECOS/ASCO Advocacy Priorities

NNECOS/ASCO Advocacy Priorities — as of May 25, 2026

↗ View full ASCO federal bill tracker
In committee introduced, pending committee action
Enacted signed into law
Ongoing active advocacy / implementation
Resolved advocacy outcome achieved
In committee
Radiation Oncology Case Rate (ROCR) Value Based Payment Program Act of 2025
Establishes a Medicare episode-based payment program for radiation oncology services, shifting from per-treatment reimbursement to patient-centered, value-based payments. Would improve access for rural and underserved patients, encourage innovation, and reduce Medicare spending.
Reintroduced March 2025 with bipartisan sponsors in both chambers. Supported by over 105 organizations. Radiation oncologists held a Capitol Hill day on May 19, 2025 to urge passage. Pending committee action in the House and Senate.
FY2026 Appropriations
Resolved
NIH Funding — Opposition to Proposed FY2026 Budget Cuts
The President’s FY2026 budget proposed cutting NIH funding by nearly 40% (from ~$46B to ~$27.9B) and restructuring the agency’s 27 institutes down to eight. NNECOS joined nearly 500 organizations opposing these cuts.
The proposed cuts were rejected by Congress. The Consolidated Appropriations Act, 2026 (P.L. 119-75), enacted in early 2026, provided $47.2 billion for NIH — a $458 million (1%) increase over FY2025 — and maintained all 27 institutes and centers. The advocacy coalition’s efforts succeeded in protecting NIH funding.
In committee
Improving Seniors’ Timely Access to Care Act of 2025
Reforms prior authorization in Medicare Advantage plans by requiring electronic prior authorization systems, establishing transparency requirements, and streamlining approval timelines to reduce delays in patient care.
Introduced May 20, 2025. Strong bipartisan support: 238 House cosponsors and 63 Senate cosponsors as of December 2025. Supported by over 200 organizations. Referred to House Energy & Commerce and Ways & Means; Senate Finance Committee.
In committee
CONNECT for Health Act of 2025
Permanently expands Medicare telehealth access by removing geographic restrictions, expanding eligible practitioners, eliminating in-person visit requirements before telemental health services, and adding program integrity provisions.
S. 1261 introduced April 2, 2025 (referred to Senate Finance). H.R. 4206 introduced June 26, 2025 (referred to House Energy & Commerce and Ways & Means). NNECOS joined ASCO in endorsing this bill.
In committee
Access to Genetic Counselor Services Act
Amends Medicare Part B to provide expanded coverage for services furnished by genetic counselors, enabling direct Medicare reimbursement for genetic counseling independent of physician supervision.
H.R. 6280 introduced November 21, 2025 (referred to House Energy & Commerce and Ways & Means). Companion bill S. 3607 introduced January 8, 2026 (referred to Senate Finance). NNECOS joined nearly 200 organizations in support. Contact your representatives using the links below.

ACT Now!

The ACT Network is your central hub for learning about and taking action on ASCO’s cancer care priorities. Here, you can send pre-drafted letters to your lawmakers on important legislative issues impacting cancer providers and their patients. Additionally, you can find information on federal legislation ASCO has formally endorsed or opposed, as well as state legislation ASCO is tracking throughout the country. Take action today!


Sign up with ASCO Act Network to let your voice be heard regarding current federal legislation that impacts patients in our region!


Thank You NNECOS Volunteers!

NNECOS leaders represented Maine, New Hampshire and Vermont during the Association for Clinical Oncology (ASCO) annual Advocacy Summit from April 20-21. Representatives spoke with congressional staffers about the following priority issues:

  • Support federally funded cancer research - support consistent funding for the NIH, NCI, and ARPA-H in FY2027. Strategic investment and predictable funding are critical to ensure the continuity and success of research, preventing both the loss of momentum and squandering prior investments.

  • Reform prior authorization mandates - Help reform prior authorization and improve patient care by passing the Improving Seniors’ Timely Access to Care Act. This bipartisan House and Senate legislation would streamline prior authorization in Medicare Advantage, hold plans accountable for their prior authorization mandates, and improve transparency.

  • Extend telehealth flexibilities - Permanently extend Medicare telehealth flexibilities and strengthen patient access to cancer care by passing the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, bipartisan House and Senate legislation. For those facing a cancer diagnosis, telehealth is more than a convenience: it is necessary for maintaining uninterrupted access to high-quality care.
The Week of Action was held in conjunction with the annual ASCO Advocacy Summit, on Capitol Hill in Washington, D.C. During the event, oncology care providers from across the United States met with Members of Congress and their staff to advocate for the Association's advocacy priorities.


Drug Shortages Sign On Letter

ASCO has launched a sign-on letter entitled: “An Open Letter from America’s Cancer Doctors and Providers.” Our goal is to gather at least 463 oncologist signatures—one signature for every day since the current crisis began—to demonstrate the widespread nature of the situation across the country and to show the community’s overwhelming support for immediate action.

In addition to the letter, there will be a video with testimonials from doctors sharing the impact of shortages on their patients, a targeted advertising campaign, and additional communications efforts.


The Importance of Advocacy

2024 State Legislation

VERMONT

VT H. 766 - a bill that would place limits on prior authorization, step therapy, and copay accumulator programs

Governor Scott signed an amended version of this bill into law on May 20, 2024. We are hopeful that, in the future, prior auth provisions can be expanded in Vermont beyond primary care. 

VT H233 - Vermont Becomes 21st State to Ban Co-Pay Accumulators

On May 30, Governor Phil Scott signed VT H. 233, a bill that requires co-pay assistance to count towards a patient’s deductible. NNECOS and Association for Clinical Oncology (ASCO) supported this measure and wrote a letter in support of this language when it was part of a different bill earlier in the session. Vermont is the 21st state to take action on co-pay accumulator programs.

 H. 766 will reduce prior authorizations, allow exemptions to step therapy, and simplify billing and other administrative burdens in health care. Please share stories about how reducing PAs can reduce healthcare costs by getting patients the right care earlier, reducing extra costs like referring patients to the ED and reducing staffing costs. 

Update: Senate - 4/23/2024 - P. 2700 - Action Calendar- Favorable report with proposal of amendment by Committee on Health and Welfare

Read the NNECOS/ASCO Joint Letter of Support

VT S. 98- concerned PDABs and UPLs could disproportionately impact oncology drugs and are particularly worried about a PDAB setting upper payment limits for physician-administered oncology drug

Read the NNECOS/ASCO Joint Comment Letter


NEW HAMPSHIRE

HB 513relative to affordability and safety of clinician administered drugs 

Hearing: September 12th - legislative tracker

Read the NNECOS/ASCO HB 513 Comment Letter

SB 354 - a bill that would prohibit health carriers in New Hampshire from utilizing co-pay accumulator programs and save patients with cancer on their out-of-pocket costs.

Read the NNECOS/ASCO SB 354 Support Letter


SB 458 - a bill that would allow for the dispensing of noncontrolled oral anti-cancer medication by a licensed healthcare professional legally authorized to prescribe and administer medications to a patient under a provider's care or supervision. 

Read the NNECOS/ASCO SB458 Support Letter

UPDATE: 2024-04-24 House Executive Session: 05/01/2024 10:00 am Legislative Office Building 210-211

MAINE

LD1577 - Expand Access to Biomarker Testing in Maine

Update 5/15/24 - Gov. Mills will not sign into law - read letter

5/10/24 - sent to Gov. Mills for signature - contact Gov. Mills - 

2024-04-11 - On motion by Senator ROTUNDO of Androscoggin PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending PASSAGE TO BE ENACTED, in concurrence.

Update - the Legislature has adjourned without funding this Bill. Updates will be posted as available. 

Coalition Website: https://www.fightcancer.org/expand-access-biomarker-testing-maine


2023 State Legislation

NH Senate committee recommends making Medicaid expansion permanent

NH SB263

Vermont Fertility Preservation 

NNECOS - ASCO Joint Letter of Support - H369

H369 - An act relating to health insurance and Medicaid coverage for fertility-related services

VT S63 - An act relating to health insurance and Medicaid coverage for fertility-related services

NNECOS - ASCO Joint Comment Letter - VT S63


Maine

12/15/23 - Comments on Revisions to Proposed 02-031 C.M.R. Chapter 865 Standards for Fertility Coverage

Maine - LD 1539

Maine Copay Fertility Preservation Bill Becomes Law

As session has adjourned, Governor Janet Mills signed Maine LD 1539, a bill providing

coverage for fertility preservation services for patients with cancer. With her signature,

Maine becomes the twelfth state to provide this coverage, with the law taking effect in 2024.


NNECOS / ASCO letter regarding LD 1539

Maine House Bill 1539 - Update 4/25/22 - sent to Governor Mills!

NNECOS and ASCO support important fertility preservation legislation in Maine. Select the thumbnail to read the letter sent to the Joint Committee on Health Coverage, Insurance & Financial Services in the Maine Legislature.

Update: On May 21, 2021, a request was submitted to carry over HB1539 to next year.

Maine - LD 1783

5/7/22 - LD 1783  becomes law without signature as Governor Mills declined to sign or veto the measure.

Maine joins Washington as the 2nd state to pass a copay accumulator elimination bill this year.

4/25/22 - sent to Governor Mills!

1/10/22 - NNECOS and ASCO send letter of support to Joint Committee on Health Coverage, Insurance and Financial Services regarding LD 1783: An Act To Require Health Insurance Carriers and Pharmacy Benefits Managers To Appropriately Account for Cost-sharing Amounts Paid on Behalf of Insureds. 


Northern New England Clinical Oncology Society
P.O. Box 643
Sandown, NH 03873-0643
Telephone (603) 887-1948
info@nnecos.org

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