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Local and National Advocacy
Thank You NNECOS Volunteers!
NNECOS leaders represent Maine, New Hampshire and Vermont during the Association for Clinical Oncology (ASCO) annual Advocacy Summit Week of Action from April 15-19. Representatives spoke with congressional staffers about the following prioirty issues:
- Help end drug shortages by acting to address the economic factors that drive generic manufacturers out of the market, reward reliable U.S. manufacturing of critical and supportive medications, recognize potential shortages earlier by increasing the Food and Drug Administration's visibility into the supply chain, and relay information about potential shortages to health systems and providers earlier to help them prepare for and mitigate possible supply challenges.
- Support federally funded cancer research by providing robust funding for the National Institutes of Health, the National Cancer Institute, and the Advanced Research Projects Agency Health for fiscal year 2025.
- Permanently expand telehealth flexibilities in Medicare by cosponsoring the CONNECT for Health Act (S. 2016 / H.R. 4189). The bill would permanently extend the telehealth flexibilities put in place for Medicare services during the COVID-19 Public Health Emergency.
The Week of Action was be held in conjunction with the annual ASCO Advocacy Summit, April 16-17, on Capitol Hill in Washington, D.C. During the event, oncology care providers from across the United States will met with Members of Congress and their staff to advocate for the Association's advocacy priorities.
ACT Now!
Prior Authorization
The Background: A 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 has endorsed the Improving Seniors’ Timely Access to Care Act (H.R. 8702/S.4532), bipartisan legislation to streamline the prior authorization process within the Medicare Advantage program. The bill was reintroduced in the Senate by Senators Roger Marshall, M.D. (KS), Kyrsten Sinema (AZ), John Thune (SD), and Sherrod Brown (OH), and in the House by Representatives Mike Kelly (PA-16), Suzan DelBene (WA-01), Larry Bucshon, M.D. (IN-08), and Ami Bera, M.D. (CA-06).
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 - include many of the Medicare Advantage prior authorization improvements we’ve been seeking. Unfortunately, several of the changes don’t 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.
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
"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
2024 State Legislative Tracker
(ASCO has transitioned its bill tracker to 2024, 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.
2024 State Legislation
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 513 - relative 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
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.
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.
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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