Access to Health Care

ACS CAN advocates for policies that provide access to treatments and services people with cancer need for their care - including those who may be newly diagnosed, in active treatment and cancer survivors.

Access to Health Care Resources:

ACS CAN responded to the reopening of the Centers for Medicare and Medicaid Services (CMS) coverage decision for NGS testing panels.

ACS CAN is concerned that over the past year, policymakers and the administration have taken several legislative and regulatory actions that could make it harder for individuals with pre-existing conditions to obtain health insurance coverage that is adequate, affordable, and available, thereby jeopardizing access to life-sustaining care.

Where healthcare dollars are spent compared with dollars on cancer care, 2015.

ACS CAN submitted comments regarding Alabama's proposed plan year 2020 Essential Health Benefit Benchmark Revisions.

ACS CAN submitted comments regarding New Jersey's request for a 1332 waiver to create a reinsurance program.

ACS CAN is very concerned about proposed policy changes that would move coverage of cancer and supportive care drugs from Part B to Part D. Proposed policy changes could jeopardize patient access to drugs, create potential safety issues, and increase out-of-pocket costs for patients who already struggle to afford cancer treatment under the current Medicare program.

In 2003, Congress passed the Medicare Modernization Act (MMA), which created an outpatient prescription drug benefit in the Medicare program. Known as Part D, the prescription benefit is operated exclusively through private insurance plans that contract with Medicare. To ensure that beneficiaries have coverage for the drugs they need Part D plans are required to cover at least two drugs in each therapeutic class. A therapeutic class is a group of medications that are used to treat the same condition. 

ACS CAN submitted comments regarding the CMS Innovation Center's request for information on a new direction.

ACS CAN comments to Steven Mnuchin and Seema Verma on Iowa's 1332 Waiver

Workforce Resources:

These comments submitted to the Institute of Medicine’s Committee on the Governance and Financing of Graduate Medical Education address ways to ensure an adequate and appropriate cancer care workforce to treat cancer patients. These comments address workforce issues in cancer care and also palliative care.

Private Health Insurance Resources:

In this letter to the Obama Administration, ACS CAN -- joined by several other organizations representing millions of American health care consumers -- urged the Administration to promptly, effectively, and fully implement the Summary of Benefits and Coverage rule.

ACS CAN filed comments to the Internal Revenue Service on the Health Insurance Premium Tax Credit proposed rule expressing deep concern about the IRS' proposed method for determining whether employment based coverage is affordable for individuals eligible for coverage through a family member's employment.

In response to the Department of Health and Human Services' proposed rule establishing health insurance exchanges and requirements for qualified health plans (QHPs) provided under the ACA, ACS CAN filed extensive comments urging HHS to ensure that the exchanges and QHPs were designed in a manner that protects consumers.

ACS CAN filed comments to the Tri-Agencies responding to the proposed rule implemeting the Summary of Benefits and Coverage (SBC) provisions provided under the ACA.  ACS CAN filed extensive comments on the proposed rule to ensure that the SBC provisions provided meaningful information to consumers regarding the coverage provided under a health plan.

This report highlights the severe challenges cancer patient may face in paying for life-saving care even when they have private health insurance.

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Medicare Resources:

The Medicare program covers 55.3 million people, including 46.3 million who qualify due to age and 9 million people who qualify on the basis of a disability.  Medicare beneficiaries - including many cancer patients and survivors - have access to an outpatient prescription drug benefit that provides them with prescription drugs needed to treat their disease or condition.  This benefit – and keeping it affordable – are crucial to any health care system that works for cancer patients and survivors.

In response to CMS’ calendar year 2017 Medicare Physician Fee Schedule proposed rule, ACS CAN filed comments supporting the proposal to expand the Diabetes Prevention Program (DPP) Model as a new Medicare preventive service because many of the interventions included in the DPP will also help beneficiaries lower their risk of developing cancer.

In response to CMS’ calendar year 2017 Medicare Hospital Outpatient Prospective Payment System proposed rule, ACS CAN filed comments suggesting changes to the Medicare and Medicaid Electronic Health Record Initiative programs and urged Medicare to develop better survey questions that seek to measure a beneficiary’s experience with pain management. 

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement providing principles for any entitlement reform proposal.

ACS CAN filed comments on the implementation of the Medicare and CHIP Reauthorization Act.

ACS CAN filed extensive comments expressing deep concern with the proposed Medicare Part B Drug Payment Model and noting that in its proposed form the Part B Drug Model Model failed to protect cancer patients' access to life-saving medications.

ACS CAN filed comments on the Advance Notice of Methodological Changes for calendar year 2017 for Medicare Advantage  capitation rates, Part C and D payment policies and the 2017 Call Letter.

ACS CAN provided comments on the proposed rule implementing changes to the Medicare Shared Savings Program in which we urged CMS to provide additional beneficiary education and require greater specificity on wasy to improve care coordination for beneficiaries.

ACS CAN provided comments on CMS' initiation of a national coverage analysis for cervical cancer screening with a combination of HPV and cytology (Pap) testing.

Disparities Resources:

Despite the fact that US cancer death rates have decreased by 26 percent from 1991 to 2015, not all Americans have benefited equally from the advances in prevention, early detection, and treatments that have helped achieve these lower rates.

On November 10, 2015, ACS CAN hosted the first National Summit on Health Equity in St. Louis, Missouri. The summit brought together over 150 innovative thinkers in public policy, business, technology, academia, patient care, community health, and patient advocacy to examine public policy solutions for assuring greater health equity for cancer patients in the evolving health care system.

The National Institutes of Health (NIH) and the National Cancer Institute (NCI) are the foundation of our national cancer research program and support research in every state. Today, that program is making remarkable progress in every area of discovery to improve cancer prevention, early detection, treatment, and care.

Health Care Delivery Resources:

Adequate and sustained investments and improvements in the prevention and early detection of disease are essential to refocusing the health care system on wellness.

Adequate and sustained investments and improvements in prevention and early detection are essential to meaningful health care reform. The Affordable Care Act took an important step in addressing these issues by creating a mandatory fund, known as the Prevention and Public Health Fund, to provide an expanded and sustained national investment in evidence-based programs that will help improve health and reduce chronic disease in our nation. 

Medicaid coverage of preventive services is essential to improving the long-term health and well-being of our nation’s most vulnerable populations. 

Ensuring access to evidenced-based cancer screenings and quality treatment is critical to the fight against colorectal cancer. 

Policymakers, providers and patients agree that the United States’ health care delivery system fails on a number of key measures – including safety, effectiveness, efficiency and patientcenteredness, among others.

Our nation’s health care system is one of the most expensive in the world. Yet the quality of care we deliver to our citizens continues to lag behind that of other industrialized nations. 

Currently, Medicare beneficiaries with a chronic disease such as cancer often receive health care services from multiple physicians and specialists who rarely coordinate care. This is not only frustrating for patients, who essentially have to understand how to access and navigate our complex health care system on their own, but it is also costly for the Medicare program.

Approximately 160 provisions in the final health care legislation will directly impact the millions of Americans who have or will face cancer. The following is a list of the most important provisions for the cancer community:

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Medicaid Resources:

ACS CAN CMS First Comments on Massachusetts 1115 Demonstration Waiver

ACS CAN CMS Comments on Arkansas 1115 Demonstration Waiver

ACS CAN CMS Comments on Wisconsin 1115 Demonstration Waiver

A Section 1115 Demonstration Waiver or Amendment gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

A Section 1115 Demonstration Waiver gives states flexibility to design and improve upon their Medicaid programs through pilot or demonstration projects.

Medicaid is the health insurance safety-net program for lower income Americans. Currently, 64 million people – many of whom are cancer patients and survivors – rely on Medicaid for affordable health care coverage.

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement providing principles for any entitlement reform proposal.

ACS CAN, the American Heart Association, the American Diabetes Association released a joint statement in support of the Medicaid program, noting that any reforms should improve the value of care provided under the program and should not reduce access for Medicaid beneficiaries.

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