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:

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 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.

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.

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

Federally Qualified Health Centers (FQHCs) are an integral part of the health care safety-net, providing access to affordable primary care services for nearly 26 million uninsured or underinsured Americans many of whom have cancer. The centers are non-profit, community-directed, and serve high need rural and urban communities that face obstacles to health care, including cost and lack of insurance, as well as geographic and language barriers. FQHCs provide access to quality preventive and primary care services that are critical for cancer patients, survivors, and those who will be diagnosed with cancer.

Prescription Drug Affordability Resources:

Many cancer patients take multiple drugs as part of their treatment – often for many months or years. While drugs are not the only costly part of cancer treatment, finding ways to reduce these costs for patients and payers will significantly reduce the overall cost burden of cancer.

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 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.

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

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).

Private Health Insurance Resources:

ACS CAN filed comments supporting the Internal Revenue Services' proposed clarification requiring plans to provide coverage for physician services and inpatient hospitalization in order to qualify as minimum value coverage. 

ACS CAN filed comments on the Medicare CY2016 Physician Fee Schedule, supporting CMS' proposals to establish a separate payment for collaborative care services and provide reimbursement for advanced care planning services.

ACS CAN provided comments on the proposed rule implementing changes to the Summary of Benefits and Coverage (SBC) and the Uniform Glossary in which we urged the Tri-Agencies to include a high-cost coverage example (specifically a breast cancer example) in the SBC, to require the inclusion of premium information on the first page of the SBC, and to eliminate the current coverage calculator and require plans to use actual plan data when providing coverage examples.

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 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.

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.

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.

Utilization management is a collection of treatment review and cost reduction techniques used by health insurers and health plans. Health plans frequently employ utilization management techniques in their prescription drug benefit, particularly for high-cost specialty medications.

Medicare Resources:

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.

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 commented in the FY2015 Medicare Hospice payment rule.

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.

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.

ACS CAN filed extensive comments in response to CMS' proposed rule implementing changes to the Medicare Part C and D programs, including opposing proposed changes to the Part D six protected classes.

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.

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Reducing Health Disparities Resources:

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.

The National Comprehensive Cancer Network® (NCCN®), ACS CAN and the National Minority Quality Forum (NMQF) share new ideas for overcoming inequality in oncology. The recommendations address how medical systems in the United States often disproportionately fail minority patients and draws on polling data to help call for urgent action.

Research shows that while overall cancer mortality rates in the U.S. are dropping, populations that have been marginalized are bearing a disproportionate burden of preventable death and disease. Researchers and policymakers need timely collection and publication of demographic data to identify disparities to improve health equity in cancer prevention, detection, and treatment.

Telehealth can help to reduce health disparities and improve health outcomes for all individuals, regardless of race, ethnicity, gender, age, sexual orientation, socioeconomic status, or zip code by providing cancer patients with a means of accessing both cancer care and primary care.

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

Medicaid Resources:

ACS CAN Comments on Montana's 1115 Demonstration Waiver.

ACS CAN Comments on Utah's 1115 Demonstration Waiver

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