Keeping Up With the Latest in Health Policy

J Clin Pathways. 2021;7(5):27.

The first 100 days of a US president’s term are considered the most important. It is the time when a president implements their big ideas and ambitious proposals, setting the standard for the rest of their term. President Biden’s first 100 days in office are over, but summer 2021 promises to be a whirlwind of activity that will affect the cancer care world. From the nomination of a Centers for Medicare & Medicaid Services (CMS) secretary to hospital transparency rules, now would not be the time to rest on one’s policy laurels.

One of the biggest questions administrators and advocates had was who will lead CMS. President Biden’s nominee for the position, Chiquita Brooks-LaSure was confirmed by the Senate on May 25, 2021. Ms Brooks-LaSure is an experienced health policy expert, having overseen the implementation of the Affordable Care Act during the Obama presidency and serving as the managing director of the health division of law firm Manatt, Phelps & Phillips afterward. 

However, even when a proposal or nomination becomes permanent, ie, a law or confirmed position, enforcing that authority can be a struggle. On January 1, 2021, a Trump administration hospital pricing proposal became law. The new law requires hospitals to publish online and in a machine-readable file the payment rates they negotiate with each payer. The thought behind this rule is ensuring consumers can make informed decisions when choosing a location to receive medical services. Unfortunately, most hospitals have been hiding this information from consumers by preventing it from appearing in Google searches or providing outdated information. With only a fine of $300 per day for noncompliance, many watchers expect CMS to institute new penalties.

Of all the hot topics, drug pricing reform may be the hottest. Reform has widespread, bipartisan support; lowering drug prices for consumers is a goal for both Democrats and Republicans. Historically, the problem has been generating a consensus between the two parties, but new proposals are even struggling to find footing in one party. It was anticipated that HR 3, the Elijah E. Cummings Lower Drug Costs Now Act, would be attached to President Biden’s infrastructure bill. A group of Democratic moderates have balked at various provisions in the bill, however, meaning it may not even survive a House vote much less receive a nay vote in the Senate. Analysts are eagerly watching for movement on the bill or the introduction of alternative proposals.

Not all drug reform has stalled, though. Reps. Terri Sewell (D-AL) and Gus Bilirakis (R-FL) have introduced the Timely Access to Cancer Treatment (TACT) Act of 2021 to help patients with cancer receive the treatment they need, when they need it. Time is of the essence in cancer treatment, but our increasingly complex health care delivery system can delay drug access. The TACT Act requires pharmacy benefit managers, plan sponsors, insurers, and pharmacies to complete the approval process for prescription oncology medication within 72 hours. If the medication is not available at that time, the bill allows patients to obtain the medication from any other appropriately licensed entity. A patient who is diagnosed with cancer doesn’t have the luxury of time, and this bill is a commonsense reform that puts patients first. This bill is brand new, but organizations like COA are watching it closely and encourage all representatives to support this patient-first bill.

That’s a lot of information to digest, even for someone who lives and breathes health policy like myself. If you want to stay abreast of the latest policy updates and improve your advocacy—grassroots and otherwise—I encourage you to attend the Virtual Community Oncology Advocacy Summit on July 21. If you want a world where cancer care is high-quality, affordable, and accessible, it is crucial to understand how to advocate for it. At the Advocacy Summit, you’ll hear the newest information on the topics discussed above and learn how to use that information to push for a better health care system. The Summit is free for patients, survivors, caregivers, advocates, advocacy non-profit groups, health care professionals in a practice setting, employers, employer health groups, business coalitions, and payers. I hope to see your name among the attendees on July 21st!