[CAZENOVIA, NY – April 27, 2023] – NCODA urges the Centers for Medicare & Medicaid Services (CMS) to immediately retract a portion of a Frequently Asked Questions (FAQ) that suggests that physician practices mailing medications would violate the federal prohibition on self-referral for ancillary services (Stark law). At present, the Public Health Emergency (PHE) that expires on May 11, 2023, waives this restriction. NCODA is concerned as this guidance would negatively impact cancer patients who rely on mailed delivery of their oral anti-cancer and supportive care drugs once the PHE expires.

With the PHE still in effect, oncology practice sites are able to mail medications to patients for their convenience. If this guidance goes into effect, it would be extremely disruptive and dangerous for patients, particularly those that:

  • Are not able to travel readily (i.e., geriatric population)
  • Require a caregiver to pick up their medications
  • May not have access to transportation
  • Live in rural communities

Additionally, if the FAQ is not rectified, Pharmacy Benefit Managers (PBMs) could take an opportunistic approach and remove practice sites from PBM networks, forcing patients to utilize a PBM owned mail-order pharmacy.

At NCODA, we continue our Mission to support oncology practices and the patients they serve. Oncology practices have been dispensing medications via mail for years for the convenience and benefit of patients in need. This has helped reduce health disparities, especially for those in underserved and rural communities. With the May 11th deadline approaching, we urge CMS to immediately retract the FAQ document pertaining to this Stark Law issue which would enable cancer patient to continue receiving their medications conveniently, timely, and coordinated with their treatment plan.


NCODA is a leading non-profit organization dedicated to empowering medically-integrated oncology practices to deliver positive, patient-centered outcomes by providing leadership, expertise, quality standards, and best practices. To learn more about NCODA visit www.ncoda.org or follow @NCODA on LinkedIn.

For More Information, Contact:
Katie Edmiston, Senior Manager of Marketing & Communications