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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.

A cohort study of 1,024 patients at an urban academic medical center discovered that 13% of oral anticancer drug prescriptions were never filled. The most common reason for failure to receive an oral anticancer drug prescription was due to patient and clinician decision-making; 13% of cases of failure to receive an oral anticancer drug prescription were directly associated with financial access issues.

With regard to his panel, “DSM-5 Text Revision (DSM-5-TR): What’s New and What’s Different,” which was presented at Psych Congress Elevate 2022, Michael B. First, MD, professor of clinical psychiatry at Columbia University in New York City, and editor and co-chair of the DSM-5-TR, responds to questions in this Q&A. The updated text’s main revisions to the “Introduction” and “Use” sections are discussed by Dr. First, who also explains the new diagnoses it now includes and provides his thoughts on how the enhanced text will help psychiatrists in their daily work.

The No Surprises Act, which went into effect on January 1, 2022, serves patients by legally protecting them from unexpected bills after receiving “emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.” But there are some doctors, like this acute-care surgeon, who believes the act is unconstitutional and is taking the federal government to court.