Updates from ASCO

• The Centers for Medicare & Medicaid Services has released its 2027 proposed rule for the Medicare Physician Fee Schedule, which ASCO estimates will result in a 1.5% overall reimbursement cut for the hematology/oncology specialty. Read ASCO's analysis of the proposed rule, including updates on the conversion factor, the G2211 complexity add-on code, and changes to the Quality Payment Program.
  

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• State Affiliate Update: Tools, Advocacy, and Resources from ASCO

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• Momentum Building for Bipartisan Prior Authorization Reform Bill

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Corporate Member News

• The Food and Drug Administration granted traditional approval to selpercatinib (Retevmo, Eli Lilly and Company) for adult and pediatric patients two years of age and older with locally advanced or metastatic solid tumors with a RET gene fusion, as detected by an FDA-approved test, that have progressed on or following prior systemic treatment or who have no satisfactory alternative treatment options. Selpercatinib received accelerated approval for this indication for adult patients in 2022 and for pediatric patients two years of age and older in 2024.

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Coding and Reimbursement Updates

• This Month’s E-Reiumbursement Newsletter from Bobbi Buell contains updates on  Eli Lilly’s 340B pricing showdown, complex new Medicare drug renegotiation rules, and stricter Medicaid work requirements. It also offers practical strategies to combat predatory insurance downcoding and previews upcoming federal policy changes.

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