Oncology Reimbursement Meeting: August 2026-Oncology Reimbursement Meeting: August 2026

Video Transcription

Video Summary

The ACCC Virtual Oncology Reimbursement Meeting opened with Emily Carroll outlining the meeting’s goal: helping oncology teams navigate changing reimbursement rules, regulations, and operational challenges. Nicole Tepe then reviewed 2026 federal policy updates, highlighting key ACCC advocacy efforts and policy wins such as a two-year telehealth extension, enactment of the National Cancer Early Detection Screening Act, and modest increases in NIH and NCI funding. She also covered major concerns around Medicaid work requirements, ACA subsidy uncertainty, prior authorization reform, workforce and student loan issues, Medicare Part B drug pricing, clinical trial support, cancer screening, and drug shortages.<br /><br />Terry Bedard followed with a detailed review of CMS proposed rules for 2027. She explained proposed changes to the Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System, including updates to conversion factors, practice expense methodology, site-of-service payment differentials, radiation oncology code valuation, proton therapy reimbursement, telehealth-related policies, modifier 25 changes, remote monitoring rules, scalp cooling valuation, and a major 340B payment proposal. She also noted revisions to the inpatient-only list, new fiducial marker codes, and changes to prostate PSMA imaging codes. Bedard emphasized how these proposals may affect community oncology practices, reimbursement stability, and access to care.<br /><br />After a break, Amy Hope discussed emerging coverage risks tied to the Inflation Reduction Act, the One Big Beautiful Bill Act, and Medicare redesign. She focused on increased Part D cost-sharing, the Medicare Prescription Payment Plan, and the need to screen patients for extra help, foundation support, and state pharmaceutical assistance. She then outlined major Medicaid and marketplace changes under HR 1, especially new immigrant eligibility restrictions, work requirements, semiannual renewals, and reduced retroactive coverage. Hope stressed proactive screening, appeals support, and trauma-informed communication to prevent treatment disruptions and financial harm.

Keywords

ACCC

virtual oncology reimbursement

federal policy updates

CMS proposed rules

Medicare Physician Fee Schedule

Hospital Outpatient Prospective Payment System

telehealth extension

National Cancer Early Detection Screening Act

Medicaid work requirements

prior authorization reform

340B payment proposal

Inflation Reduction Act

Medicare Part D cost-sharing

patient financial assistance

community oncology reimbursement