American Cancer Society Cancer Action Network Issues Letter to CMS Applauding Its Commitment to Expanded, Sustainable Access to Patient Navigation Services

CMS Proposes New Medicare Reimbursement Strategy for Patient Navigation Services to Better Serve Patients with Serious Illnesses

September 11, 2023

WASHINGTON, D.C. – September 11th, 2023 – Late Friday, the American Cancer Society Cancer Action Network (ACS CAN) issued a letter to the Centers for Medicare and Medicaid Services (CMS) commenting on the proposed rule for the 2024 Medicare Physician Fee Schedule. 

CMS is proposing a new reimbursement code for patient navigation services focused on patients with serious illnesses like cancer. The letter acknowledges the proposal by CMS to better support cancer patients by increasing access to patient navigation services.   

“We applaud CMS for its commitment to create additional support for patients with serious, high-risk illnesses like cancer by addressing complex aspects of their care,” noted Dr. Karen E. Knudsen, ACS CAN CEO. “Patient navigation is proven to help increase cancer screening rates, help patients better understand treatment options after diagnosis and ensure patients receive the post-treatment care they need in survivorship; still, too many patients are unable to access such critical services. A reimbursement strategy that ensures services are paid for in the long term is a meaningful first step towards expanded and sustainable access to patient navigation.” 

Successful navigation of health care barriers for patients undergoing cancer treatment involves the deployment of skills and care plans unique to other diseases like heart failure and chronic respiratory disease – making care more manageable for patients by providing additional support through professionally-trained individuals. According to a 2022 survey by ACS CAN, an overwhelming majority of patients and survivors (91%) agree that having access to a patient navigator is very important for cancer patients. However, only 54% of surveyed individuals had encountered a patient navigator. 

The American Cancer Society (ACS) and ACS CAN have been long-standing advocates of the important role patient navigation services play in survivorship against cancer. Last month, under the leadership of ACS, several member organizations of the ACS National Navigation Roundtable committed to playing a leading role in training and establishing certification standards that comport with the requirements provided in the proposed rule. 

Additionally, patient navigation has been shown to help address health-related social needs and reduce disparities in communities of color by providing access to disease prevention education, conducting community outreach and facilitating public education campaigns. 

“Navigating the complexities of a cancer diagnosis is challenging for anyone, but it is particularly difficult for underserved populations who face a disproportionate number of barriers within our confusing and complicated health care system,” added Lacasse. “We look forward to continuing to work with CMS to ensure more individuals have access to professionally trained navigators who can help reduce the cancer burden for every patient and their family.” 

As part of the letter, ACS CAN also commented on proposed provisions related to improving access to telehealth services and removing health-related social barriers to care.  

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