March 2024
ASH Committee on Government Affairs Members Visit Capitol Hill in Support of SCD and Public Health Funding
Following the ASH Committee on Government Affairs spring business meeting, members of the committee visited Capitol Hill on Tuesday, March 12, to urge Members of Congress to support individuals living with sickle cell disease (SCD) by cosponsoring the Sickle Cell Disease Comprehensive Care Act (H.R. 7432). This bipartisan legislation, which is strongly supported by ASH, aims to ensure that individuals with sickle cell disease (SCD) have better access to comprehensive, high quality outpatient care, including recommended clinical, mental health, ancillary, and support services by allowing states to establish Medicaid Health Home programs with SCD as the single qualifying condition for eligibility.
ASH members also urged Members of Congress to finalize fiscal year (FY) 2024 appropriations and provide increased funding for the National Institutes of Health (NIH), the Department of Defense (DoD) Congressionally Directed Medical Research Programs, and the Sickle Cell Data Collection program at the Centers for Disease Control and Prevention (CDC) in FY 2025.
CMS Releases National Coverage Determination for Allogenic Hematopoietic Stem Cell Transplantation for MDS
On March 6, the Centers for Medicare & Medicaid Services released a final decision memo on the national coverage determination (NCD) for Allogenic Hematopoietic Stem Cell Transplantation for Myelodysplastic Syndromes, effective immediately. ASH along with partners that included ASTCT, BMTCTN, CIBMTR and NMDP submitted comments when the proposed decision memo was released. The comment letter included supporting evidence for the use of cord blood stem cell products as a donor source and the use of additional recognized scoring systems and risk designations. CMS had originally proposed that cord blood be excluded as a donor source and proposed that only the International Prognostic Scoring System-Revised could be used to determine when a patient qualified for a stem cell transplant. The final decision memo outlined the inclusion of cord blood as a donor source and CMS will allow the use of other recognized risk scoring systems. ASH staff will continue to analyze the policy and provide additional updates; ASH views this as an important win for Medicare patients with MDS, who will now have greater access to this treatment option.
ASH Joins Coalition Letter for Telehealth Policy
ASH joined over 200 organizations in a coalition letter urging Congress to take action on telehealth policy. The letter advocates for strengthening several telehealth policies, including creating certainty for Medicare beneficiaries around the continuation of telehealth services, strengthening virtual staffing models, continuing investment in technology and infrastructure, offering flexibility for health plans to leverage telehealth, and asking for clear guidance from Congress for a long-term approach to telehealth flexibilities. Increasing access to health care delivered virtually aligns with ASH’s commitment to improving access to care, and ASH plans to continue advocating for telehealth policies by joining other health care organizations in endorsing the Telehealth Modernization Act when it is introduced.
ASH Submits Comments on Medicare Dental Letter
In late 2023, the Centers for Medicare & Medicaid Services (CMS) finalized the CY 2024 Medicare Physician Payment Fee Schedule (MPFS), including a provision for dental coverage linked to other covered services. ASH submitted additional comments to CMS applauding the Agency’s efforts to expand coverage for dental services linked to chemotherapy, CAR T-Cell therapy, and the administration of high-dose bone-modifying agents (antiresorptive therapy), all when used in the treatment of cancer. ASH also recommended CMS include coverage for dental services following organ transplantations (including bone marrow or hematopoietic stem cell transplantations) and recommended the coverage for dental services related to cell and gene therapies for future consideration.
Draft Guidance Part Two for the Medicare Prescription Payment Plan is Open for Comment
The Centers for Medicare & Medicaid (CMS) has released the second of two draft guidance documents that provide information on the Medicare Prescription Drug Payment Plan, a program established under the Inflation Reduction Act of 2022. The Payment Plan was created to reduce the burden of Part D drug costs by allowing Medicare beneficiaries to pay for out-of-pocket prescription drug costs using a monthly payment plan. The payment plan option will be ready for use on January 1, 2025.
Part one guidance for the payment plan provided information and policies on the operational and technical issues of the program, while part two focuses on education, outreach, and communication for the plans, providers, pharmacies and beneficiaries. With the release of the guidance the agency also published a fact sheet that provides answers to common questions of the payment plan program.
The Society submitted comments on the draft guidance and will provide more information as it becomes available from CMS.
