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 provided comments on CMS' Draft 2016 Letter to Issuers in the Federally-facilitated Marketplaces, including comments related to network adequacy, provider directories, nondiscrimination provisions, and other issues.

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.

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.

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.

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.

ACS CAN commented in the FY2015 Medicare Hospice payment rule, in which we urged, among other things, for Medicare to develop a workable solution to better clarify when a prescription drug is covered under the Hospice or Part D benefit.

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.

A comprehensive plan to address all barriers is necessary to make prevention a national priority.

Prescription Drug Affordability Resources:

Many cancer patients have difficulty affording the cost of their prescription drugs, regardless of whether they are insured.  This is especially true for newer drugs that do not have a generic equivalent.  Many programs exist to help patients afford their medication.  This fact sheet focuses on two of these – patient assistance programs and discount coupons.  

ACS CAN joined organizations representing cancer patients, survivors, providers, and caregivers urging the administration to address barriers to access to care and coverage during the public health crisis

ACS CAN joined 50 groups representing, cancer patients, survivors, doctors, nurses, cancer centers, pharmacists and researchers urging Congress to address barriers to patient access to care and coverage.

The Medicare Access for Patients Rx (MAPRx) Coalition raises concerns about proposed changes to the Medicare prescription drug benefit and Medicare Advantage plans

The American Cancer Society Cancer Action Network (ACS CAN) appreciates the opportunity to comment on the 2021 Notice of Benefit and Payment Parameters proposed rule. ACS CAN is making cancer a top priority for public officials and candidates at the federal, state, and local levels.

ACS CAN supports legislative and regulatory policies at the state and federal level that prohibit patients from being surprise billed for unexpected out-of-network care.

ACS CAN comments to Secretary Alex Azar on Drug Rebate Proposed Rule

Biological drugs, commonly referred to as biologics, are a class of drugs that are produced using a living system, such as a microorganism, plant cell, or animal cell. Like all drugs, biologics are regulated by the United States Food and Drug Administration (FDA).

For an individual with specific health care needs – like cancer patients and survivors – the drugs covered by a health plan and corresponding cost sharing for each drug is important information when choosing health insurance. However, to make an informed choice, formulary information must be disclosed to the individual.

Private Health Insurance Resources:

ACS CAN submitted comments on September 16, 2020, to CMS regarding Georgia's 1332 waiver application.

The American Cancer Society Cancer Action Network (ACS CAN) appreciates the opportunity to comment on the 2021 Notice of Benefit and Payment Parameters proposed rule. ACS CAN is making cancer a top priority for public officials and candidates at the federal, state, and local levels.

ACS CAN applauds the intent of the proposed rule, which is to provide consumers with information regarding their expected out-of-pocket health care costs for items and services before they receive care.

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

 

Medicare Resources:

ACS CAN Comments to Seema Verma, Administrator, Centers for Medicare and Medicaid Services

Letter in support of Medicare coverage for CAR-T therapies.  

ACS CAN submitted comments on the Medicare Part C and D Rule.

Approximately 1.7 million new cancer cases are expected to be diagnosed in 2018. Age is one of the most important risk factors for cancer, with one half of cancer cases occurring in people over the age of 65.

Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates.

On January 16, 2018, ACS CAN filed comments in response to CMS’ proposed rule implementing changes to the Medicare Part C and Part D programs. ACS CAN commented on a number of proposed policies.

ACS CAN submitted comments regarding the Centers for Medicare and Medicaid Services' Survey called Innovation Center New Direction. The comments addressed: advanced alternative payment models, consumer-directed care & market-based innovations, physician specialty models, prescription drug models, and Medicare Advantage models.

ACS CAN submitted comments supporting CMS' propsoal related to CMS' laboratory date of service policy.

Reducing Health Disparities Resources:

Despite notable advances in cancer prevention, screening, and treatment, not all individuals benefit equally from this important progress. This fact sheet provides an overview of current health disparities in cancer care and a snapshot of ACS CAN federal advocacy activities to eliminate these disparities and achieve health equity.

In order to reduce cancer mortality we must fight to achieve health equity, the just and fair opportunity for everyone to prevent, find, treat and survive cancer. This document shows a snapshot of how ACS CAN is fighting for health equity at the national, state and local levels.

Research is critical to understanding and reducing cancer disparities, as well as examining gaps in cancer prevention and care delivery that contribute to these disparities. Clinical trials are a key part of research and enable the development of better drugs and treatments for cancer.

All individuals should have equitable access to quality cancer care and equal opportunity to live a healthy life. Our ability to continue to make progress against cancer relies heavily on eliminating the inequities that exist in cancer care.

Although tobacco-related cancer incidence and mortality have declined in the U.S., we continue to see disparities by socioeconomic status (SES), race/ethnicity, educational level, gender, sexual orientation, and geographic location. Our ability to continue to make progress against cancer relies h

Our ability to continue to make progress against cancer relies heavily on eliminating the inequities that exist in the prevention and early detection of cancer. This factsheet explores how health outcomes vary across groups, barriers to cancer screenings, and how ACS CAN is taking action.

In response to a request from FDA, ACS CAN has provided recommendations for areas of focus for the Office of Minority Health and Health Equity (OMHHE).  Recommendations include assessing the applicability of drug "snapshot" data, evaluating the appropriateness of aggregating racial groups for ana

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.

Costs and Barriers to Care Resources:

ACS CAN supports legislative and regulatory policies at the state and federal level that prohibit patients from being surprise billed for unexpected out-of-network care.

Many patients with complex diseases like cancer find it difficult to afford their treatments – even when they have health insurance.  Current law establishes a limit on what most private insurance plans can require enrollees to pay in out-of-pocket costs.  These limits protect patients from extremely high costs and are essential to any health care system that works for cancer patients and survivors.

 

This report explores the experiences of cancer patients with their health insurance and financial challenges through interviews with hospital-based financial navigators. The report finds that while the Affordable Care Act has brought crucial improvements to patient access to health insurance, cancer patients still face serious challenges affording their care and using their insurance benefits.

As Congress debates enacting changes to the health care market, one concept re-emerging is state high-risk pools to provide health insurance coverage for individuals who otherwise cannot obtain or afford coverage. High risk pools are not a new concept. Prior to the enactment of the Affordable Care Act (ACA) many states operated some form of high risk pool. During implementation of the ACA, a federal high risk pool was established as an interim step to the new marketplaces. The overall success of high risk pools varied. This fact sheet examines how state risk pools work and the impact on persons with cancer and cancer survivors.

Current federal requirements prohibit health insurance plans from denying coverage to individuals with pre-existing conditions like cancer.  These are one of several important patient protections that must be part of any health care system that works for cancer patients.

Current federal law has several provisions that help prevent individuals and families from experiencing gaps in their health insurance coverage.  Coverage gaps can delay necessary care, which is particularly detrimental to cancer patients and survivors.  Preventing gaps in coverage is a crucial patient protection that must be maintained in our health care and insurance system.

Current federal law provides life-saving coverage of cancer prevention and early detection services and programs.  These provisions are crucial to reducing the incidence and impact of cancer in the United States.  They are also crucial in helping cancer survivors remain cancer-free and lead healthy lives.

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.

The health care law has several provisions that help prevent individuals from experiencing gaps in health insurance coverage, including the requirement that private health insurance plans allow dependents to remain on their parents’ insurance until age 26.  This provision is important for keeping survivors of childhood and young adult cancer insured, and helps to ensure young adults receive preventive services and screenings.  This provision is a crucial patient protection that must be a part of a health care system that works for cancer patients and survivors.

Medicaid Resources:

ACS CAN CMS Comments on New Mexico's 1115 Demonstration Waiver

ACS CAN CMS Comments on South Carolina's 1115 Demonstration Waiver

ACS CAN CMS Comments on Tennessee's 1115 Demonstration Waiver

ACS CAN CMS Comments on Virginia's 1115 Demonstration Waiver

ACS CAN CMS Comments on Michigan's 1115 Demonstration Waiver

ACS CAN CMS Comments on Alabama's 1115 Demonstration Waiver

ACS CAN CMS Comments on Kansas 1115 Demonstration Waiver

ACS CAN CMS Comments on North Carolina 1115 Demonstration Waiver

ACS CAN CMS Comments on New Hampshire 1115 Demonstration Waiver