Congress passed a six-part spending bill on March 8, 2024, that funds several government agencies, including the Food and Drug Administration (FDA), through Sept. 30, 2024—the end of the fiscal year.

The legislative package, which the president later signed, also contains a 1.68% increase to the Medicare physician reimbursement rate until Dec. 31, 2024. The increase partially reduces the 3.37% reimbursement cut that went into effect on January 1, which was on top of last year’s 2% physician payment reduction. The bill additionally extends Advanced Payment Model (APM) bonuses at 1.88%, though that is down from 3.5% in prior years. Finally, the bill extends APM eligibility thresholds in effect for performance year 2023 through payment year 2026.

During the lead up to this legislation, the Association for Clinical Oncology (ASCO) advocated for Congress to address the full 3.37% Medicare physician reimbursement cut and make much needed, long-term reforms to the flawed payment system to improve patient access to cancer care and support the sustainability of oncology practices.

“While we appreciate congressional attention, we are disappointed that Congress failed to eliminate the physician fee schedule cut in its entirety,” said Everett E. Vokes, MD, FASCO, Chair of the Board, Association for Clinical Oncology. “In the last three decades, physician reimbursement has fallen behind inflationary rates by 26%. That alarming statistic, along with increased performance thresholds, limitations on resources, and lack of incentives to transition to value-based care models only amplify the unsustainable Medicare physician payment system. We will continue to advocate for Congress to take steps to reform the flawed Medicare physician payment system and improve financial stability for practices.”

The funding bill allocates more than $6.7 billion to the FDA for FY24 (including user fees), which is level funding with FY23. This also includes $3.52 billion in discretionary budget authority—about $4 million less than ASCO requested—and a mandate to address drug and device shortages.

“We realize this has been a difficult year for appropriators but were also hopeful lawmakers could have found a way to increase funding for the FDA, which plays a crucial role in protecting our nation's public health by overseeing the safety, effectiveness, and security of a wide range of products, including drugs and medical devices,” Dr. Vokes said. “As we look to FY25, ASCO remains committed to advocating for the funding required to support the FDA in fulfilling its critical mission."

ASCO also supported the following programs, which were included in the bill:

• $50 million was allocated for the Cures Act.
• More than $2.3 billion designated for the FDA’s Center for Drug Evaluation and Research.
• $684.3 million for the Center of Tobacco Products.

Additional highlights:

• FDA was directed to repurpose at least $50 million of its budget to support priority issues, including drug and device shortages.
• In line with the updated Family Smoking Prevention and Tobacco Control Act, appropriators noted that to date, FDA has not granted any authorizations for synthetic products and “strongly urged” the Center for Tobacco Products to immediately remove any product containing synthetic nicotine from the market whether or not such product is the subject of a pending Premarket Tobacco Product Application (PMTA) filed in 2022, until such applications for synthetic products are authorized.

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