On December 29, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule rescinding the Most Favored Nation (MFN) model. MFN was originally proposed in November 2020 and scheduled to be implemented on January 1, 2021. ASCO and other groups strenuously opposed what would have been a mandatory model that would have decimated cancer care in the United States by significantly decreasing Medicare beneficiary access to treatment.
ASCO’s analysis showed that oncology practices would have struggled to provide appropriate therapy to their patients under MFN. CMS acknowledged that under the model, up to 19% of beneficiaries could lose access to care, and approximately 10% of patient care would be shifted from impacted private practices to 340B-qualified hospitals or Prospective Payment System (PPS)-exempt hospitals.
ASCO opposed MFN since its release and submitted detailed comments to CMS outlining the significant impacts the model would have on cancer care. ASCO also submitted an amicus curiae brief in support of four cases to enjoin the model. As a result of the legal efforts to halt implementation of the model, a California court issued a nationwide preliminary injunction in late December 2020, blocking CMS from implementing the model until the agency followed rulemaking procedures required by law.
ASCO commended CMS for its proposal to withdraw MFN in August 2021 and applauds CMS now for finalizing this rule and rescinding the model. ASCO will continue to work in good faith with the administration toward the shared goal of controlling the rising cost of cancer drug treatments. However, ASCO will also continue to oppose any model that threatens Medicare beneficiary access to essential cancer care.
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