NCODA, a non-profit organization empowering medically integrated oncology practices to deliver positive, patient-centered outcomes, has launch a new and unique, comprehensive Oncology State Legislation Tracking Tool.
This new resource is the first-of-its-kind within the oncology space that allows healthcare professionals and other users to stay up-to-date on the latest in state legislation pertaining to issues such as Pharmacy Benefit Managers (PBMs) and copay accumulators*, which are designed to limit the impact of manufacturer contributions on a patient’s deductible and out-of-pocket costs. [1]
Unlike other state legislation trackers, this tool encompasses all updates throughout the United States in one location, and is updated on a weekly basis.
“This tool is revolutionary in how much of an impact it will make for all practices that are trying to navigate state health policy change,”noted Debra Patt, MD, PhD, MBA, Executive Vice President at Texas Oncology states.
“It’s difficult for state practices to be involved in policy, and NCODA’s Oncology State Legislation Tracker is really going to help us be up-to-date on the recent policy changes in different states to help each state understand how and where they need to act to be effective,” Patt added.
Why this is important
The NCODA Oncology State Legislation Tracking Tool will include relevant bill numbers, complete bill readings, as well as a brief summary and a ‘why it matters’ section for each bill. This tool allows busy healthcare professionals to become more active participants in their state’s legislative affairs that directly impact their practice and the patients they serve. Users will also have access to dozens of FAQs on the tracker’s webpage which explain specific healthcare and legislative terms / phrases.
NCODA has a dedicated and active membership base of professionals that are part of their Legislative & Policy Advisory Committee. The committee is led by Nancy Egerton, PharmD, BCOP.
“This new tool will connect oncology professionals across the country in a way that will allow voices to be heard much quicker, more effectively, and on common ground,” said Nancy Egerton, PharmD, BCOP, who is the Director of Pharmacy at New York Oncology Hematology in Albany, NY
“Keeping our members engaged and informed of key issues relevant to their practices and patients is the goal of the Legislative & Policy Advisory Committee, and this tool will allow us to be much more efficient in our efforts,” she added.
NCODA serves over 4,700 healthcare professionals from close to 800 unique cancer centers across the country. In addition to the many member resources that NCODA offers, the Oncology State Legislation Tracking Tool is a valuable way for the oncology community to be informed on recent state legislative issues.
This information will allow healthcare providers from across the country to work together and bring about change to improve the patient experience. Beyond viewing the information contained in the tool, NCODA has also launched a member-only online engagement community called “NCODA CONNECT”. This engagement platform allows for further discussion between healthcare professionals based on recent legislative updates, thus making the connection even deeper and more efficient for all participants.
“This new tool provides tremendous value. As PBM reform and legislation get so complicated, state reform becomes a key driver in impacting change to improve patient care. Having a tool to understand best practices across different states to see what is going on, what is working and what hasn’t worked, really allows healthcare professionals to bring better change and learn from other states,” said Stephen M. Schleicher, MD, Chief Medical Officer at Tennessee Oncology.
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Note
*Copay accumulators are also known by other names, including Out-of-Pocket Protection Program (Express Scripts), True Accumulation (Caremark) and Coupon Adjustment: Benefit Plan Protection Program (UnitedHealthcare). While drug manufacturers offer copay savings programs to help patients afford expensive brand medications, as well as specialty drugs, and provide financial relief to patients who have trouble affording their prescription drug copay by offsetting out-of-pocket costs, insurance companies and PBMs are actively prohibiting all copay payments made using a manufacturer copay savings program from counting towards a patient’s deductible and annual maximum out-of-pocket costs. Describing this process as “risk adjustment,” The Centers for Medicare and Medicaid Services (CMS) approves this prohibition allowing insurers to implement these programs without restriction.[2]
Reference
[1] Nabhan C, Phillips EG Jr, Feinberg BA. How Pharmacy Benefit Managers Add to Financial Toxicity: The Copay Accumulator Program. JAMA Oncol. 2018 Dec 1;4(12):1665-1666. doi: 10.1001/jamaoncol.2018.4554. PMID: 30286215.
[2] Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental PlansA Rule by the Health and Human Services Department on 05/14/2020. [Article]
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