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The merit-based incentive payment system (MIPS), which adjusts clinician Medicare Part B payments for performance on quality, cost, improvement activities, and use of certified EHR technology for interoperability, along with EOM quality measurement systems for Medicare, should ideally be meaningful to physicians and patients and coordinated to magnify the quality signal. How do these novel methods compare, then, in terms of genuinely comprehending the standard of cancer care provided to Medicare beneficiaries?

For some of the most often applied treatments for meibomian gland dysfunction (MGD), such as imaging, exfoliation therapy, heat therapy, strong pulsed light therapy, and meibomian probing, Myranda Partin, OD, offers advice, coding, and reimbursement information.

According to a survey conducted by the Association for Clinical Oncology, the majority of respondents (96%) said prior authorization has led to delays in cancer treatment, with 80% claiming prior authorization has enabled disease progression, and 36% of them saying prior authorization has led to patient deaths. 300 ASCO members who work in academic or university (29%) settings, private practice (34%), or community or hospital-based health network/systems (35%), completed the survey.

A video conversation between a senior advisor at ADVI, a physician from Texas Oncology, and the division director of practice health for ASCO discuss the main provisions of the Inflation Reduction Act (IRA) and its implications for oncologists and oncology practices. The panel discusses why practices may have to bear a larger share of the cost of drugs and be ready for utilization cuts by focusing on two important aspects of the IRA: the $2,000 cap on patients’ out-of-pocket expenses and Medicare price negotiation. All three concur that if the act isn’t changed, it might slow down the development of medicines for some indications.

In a three-page letter, Kathryn A. Coleman, director of the agency’s Medicare Drug and Health Plan Contract Administration Group, stated that CMS is immediately stepping up its examination of marketing materials, which are required to be submitted in accordance with its legal “File and Use” authority for Medicare Advantage and Part D drug plans, and “may exercise its authority to prohibit” their use. As of right now, Medicare Advantage marketing materials are allowed to go live five days after being submitted, as long as the company submitting them “certifies the material complies with all applicable standards.” Starting January 1, 2023, however, no television advertisements will be eligible for submission under its “File and Use” authority, meaning that the advertisements will not air until CMS approves them.

All eligible Medicare beneficiaries who received treatment at Mayo facilities in Arizona and Florida over the previous three years were sent letters this past fall urging them to sign up for original Medicare and a supplement. When asked about the purpose of the letters, Kevin Punsky, the Mayo communications manager, said that they are meant to act as “a courtesy reminder” at the start of the annual Medicare re-enrollment window, which started on October 15.