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.

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 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).

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 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.

ACS CAN submitted comments regarding a proposed rule to change Health Reimbursement Arrangements (HRAs) and other account-based group health plans.

ACS CAN submitted comments to CMS regarding Maryland's proposal for a 1332 reinsurance waiver.

ACS CAN submitted comments on July 3, 2018 to CMS regarding Maine's 1332 waiver application to create a reinsurance program.

Medicare Resources:

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.

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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Costs and Barriers to Care Resources:

Consumers need access to health insurance policies that cover a full range of evidence-based health care services – including prevention and primary care – necessary to maintain health, avoid disease, overcome acute illness and live with chronic disease.  Any health care system that works for cancer patients must have standards ensuring that enrollees have access to comprehensive health insurance.

Current federal requirements prohibit most insurance plans from limiting both the lifetime and annual dollar value of benefits.  This ban is one of several important patient protections that must be part of any health care system that works for cancer patients.

 

 

Current federal requirements provide crucial protections that ensure health insurance coverage is comprehensive, not arbitrarily limited, available to all and more affordable.  These protections are especially important for cancer patients, survivors, and those at risk for cancer.  This fact sheet contains a list of the most important provisions in current law for the cancer community.

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.

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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