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Episode 6 - Recommended Guidelines and Payer Challenges
Treatment guidelines are now recognizing and suggesting immunotherapy for the treatment of several types of cancer.
However, Jeffrey Weber, MD, PhD, explains that the unspoken issue in regard to immunotherapies is that most are investigational. With respect to a payer covering treatment, in different states throughout the country, some will cover research-related costs and some will not.
As the panelists discuss how coverage inconsistencies, or the lack of coverage altogether, challenges providers to offer treatment as suggested by important NCCN guidelines, Daniel J. George, MD, concludes that there is no real way to develop a standard policy without reviewing each case individually.
Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays
June 19th 2025Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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Culture Key to Data Collection of Sexual Orientation and Gender Identity in Cancer Care
June 23rd 2025This research highlights the key factors, like leadership buy-in, mandatory protocols, and electronic health record workflows, that influence the effective collection of data on sexual orientation and gender identity in outpatient oncology clinics to improve patient-centered care.
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