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 filed comments on the 2016 Notice of Benefit and Payment Parameters proposed rule, including comments related to Special Enrollment Periods, prescription drug benefits, nondiscrimination, cost-sharing requirements, network adequacy standards, and other issues.

ACS CAN commented on the Medicare CY2015 Physician Fee Schedule, in which we urged, among other things for CMS to designate screeming colonoscopioes that resule in polyp removal or biopsy as a preventive service.  We also commented on the proposed provisions related to the Chronic Care Management code.

As the National Association of Insurance Commissioners (NAIC) updated its Managed care Plan Network Adequacy Model Act (Network Adequacy Model Act), ACS CAN filed comments urging the NAIC to adopt policies that would ensure that health plan networks are sufficient to provide enrollees with access to a sufficient number and type of providers (including oncology services) to meet the needs of the enrollees.

For persons living with cancer, access to specialty practitioners is paramount. Millions of Americans are now choosing health coverage through the new insurance Marketplaces and these enrollees need to be able to easily determine whether specific physicians are in a plan’s network.

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

ACS CAN filed comments in response to the Center for Medicare & Medicaid Innovation's (CMMI's) request for information on specialty practitioner payment model opportunities.  ACS CAN's comments urged CMMI to pay particular attention to the impact various payment policies would have on a beneficiary's access to care.

In a letter to CMS Administrator Tavenner, ACS CAN joined other organizations urging CMS to reqire Medicare Advantage plans to provide coverage for clinical trials.

This analysis examines two issues of particular interest to the American Cancer Society Cancer Action Network (ACS CAN) and its members: the extent of coverage and cost-sharing for cancer drugs, and whether information on the coverage of cancer drugs can be readily obtained, compared, and understood by patients.

This analysis examines two issues of particular interest to the American Cancer Society Cancer Action Network (ACS CAN) and its members: the extent of coverage and cost-sharing for cancer drugs, and whether information on the coverage of cancer drugs can be readily obtained, compared, and understood by patients.

Private Health Insurance Resources:

ACS CAN Comments on Rhode Island 1332 Reinsurance Waiver Proposal

ACS CAN Comments on Montana 1332 Reinsurance Waiver Proposal

ACS CAN Comments on Delaware's 1332 Reinsurance Waiver Proposal

 

ACS CAN Comments on Colorado 1332 Reinsurance Waiver Proposal

ACS CAN Comments on North Dakota 1332 Reinsurance Waiver Proposal

Last year, the Administrative finalized a regulation that expands access to short-term, limited-duration insurance products. Short-term plans were originally intended to bridge gaps in comprehensive coverage – for instance, when an individual was between jobs and temporarily without access to an employer plan.

ACS CAN Comments on Interstate Sale of Insurance

ACS CAN submitted comments regarding the 2020 Proposed Notice of Benefit & Payment Parameters for the individual insurance market.

ACS CAN submitted comments on the proposed 2019 CMS Program Integrity Rule.

Costs and Barriers to Care Resources:

ACS CAN comments on 2015 Edition EHR Standards and Certification Criteria Proposed Rule

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.

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

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Medicaid Resources:

An estimated 2.2 million low-income adults who would benefit from Medicaid if their state expanded coverage are now in the “coverage gap,” uninsured and unable to qualify for affordable health insurance. Congress must extend quality, affordable coverage to people who need it by closing the Medicaid coverage gap. 

ACS CAN submitted comments opposing Tennessee's proposal to fund its Medicaid program through a block grant and implement a closed formulary.

ACS CAN comments supporting Medicaid expansion in Oklahoma, but opposing their proposal to rescind retroactive eligibility

ACS CAN's comments on the proposed extension of Arizona Health Care Cost Containment section 1115 demonstration.

ACS CAN comments on Georgia's 1115 Demonstration Waiver.

ACS CAN comments on Nebraska's 1115 Demonstration Waiver.

An increasing number of states are seeking greater flexibility in administering their Medicaid programs. The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) give states the opportunity to test innovative or alternative approaches to providing health care coverage to their Medicaid populations through Section 1115 Research and Demonstration Waivers (otherwise known as "1115 waivers"). States must demonstrate that their waivers promote the objectives of the Medicaid and Children’s Health Insurance Programs (CHIP) and CMS must use general criteria to determine whether the objectives of the Medicaid/CHIP programs are met.