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 the ACA market stabilization rule.

ACS CAN Comments on Special Enrollment Period Verification Pilot Program

ACS CAN Comments on Short-Term Policies

ACS CAN Recommendations for Updating the NAIC's Managed Care Plan Network Adequacy Model Act.

ACS CAN Comments on Proposed Changes to Special Enrollment Periods

These comments were submitted by ACS CAN to the U.S. Department of Health and Human Services regarding changes to the template Summary Plan Document that health insurance plans must provide to consumers.

In a letter to the National Association of Insurance Commissioners (NAIC), ACS CAN and other organziations provided specific comments to provide greater consumer protections and improvements to  the NAIC's Health Carrier Prescription Drug Benefit Model Act (Formulary Model Act). 

ACS CAN filed comments on the 2017 Notice of Benefit and Payment Parameters, including issues related to Medicare notices, standardized plan option designs, and network adequacy.

A recent American Cancer Society Cancer Action Network (ACS CAN) analysis of coverage of cancer drugs in the health insurance marketplaces created by the Affordable Care Act has found that coverage transparency has improved somewhat since 2014, but significant barriers remain for cancer patients.

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:

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

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. 

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

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. 

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 Comments on Massachusetts 1115 Demonstration Waiver

ACS CAN CMS Comments on Maine 1115 Demonstration Waiver

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

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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