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:

A link to HealthCare.gov, the Health Insurance Web Portal.

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 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.

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.

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.

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:

ACS CAN Examination of Cancer Drug Coverage and Transparency in the Health Insurance Marketplaces

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.

The Affordable Care Act (ACA) expanded access to health insurance through reforms of the private health insurance market, including income-related premium support and cost-sharing subsidies and establishment of Health Insurance Marketplaces.

Medicare Resources:

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.

ACS CAN commented on CMS' Accountable Care Organizations (ACOs) proposed rule. Our comments offered specific recommendations to improve the ACO program to better serve the needs of cancer patients and survivors.

Cancer patients and others who may suffer from multiple chronic conditions or long-term side effects from treatment would benefit from payment reform in Medicare.

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:

Provides information about enrolling in Medicare, including Part D prescription drug coverage, what Medicare covers, and how to contact Medicare with questions

Resources and information from the American Cancer Society about understanding health insurance, particularly for cancer patients and survivors.

The American Cancer Society operates a call center available to all cancer patients and their families, that includes resources and specialists who can help patients with questions about health insurance, enrolling in a plan, and issues accessing care.

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

ACS CAN comments on Medicare and Medicaid Programs; Electronic Health Record Incentive Program – Stage 3 Notice of Proposed Rulemaking

ACS CAN Comments on ASCO's Proposed Value Framework

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.

The Affordable Care Act (ACA) expanded access to health insurance through reforms of the private health insurance market, including income-related premium support and cost-sharing subsidies and establishment of Health Insurance Marketplaces.

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

Medicaid Resources:

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

ACS CAN CMS Comments on Massachusetts 1115 Demonstration Waiver

The Children's Health Insurance Program (CHIP) is an integral part of the safety-net for lower-income children and their families. CHIP provides access to quality, affordable, and comprehensive health care coverage to nearly nine million lower income children up to age 19 in the U.S. – many of whom have been affected by cancer.

ACS CAN CMS Comments on Maine 1115 Demonstration Waiver

ACS CAN CMS First Comments on Massachusetts 1115 Demonstration Waiver