Learn about the real life impact of prior authorization from two cancer patients who have dealt with this issue firsthand.
Cancer Patients, Recent Survivors Should Be Exempt From Possible Medicaid Work Requirements
CMS Needs to Clearly Define Who Qualifies As “Medically Frail”
Washington, D.C.—January 11, 2018—Today the Centers for Medicare and Medicaid Services (CMS) issued guidance allowing states to require “able-bodied” adults to work, participate in job training or volunteer in order to receive Medicaid health benefits. As part of the guidance, CMS exempts children, pregnant women, the disabled and those who are deemed, “medically frail,” however the guidance does not clearly define who would be considered medically frail.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:
“Today’s guidance could mean a significant change to one of America’s most essential safety-net programs. Medicaid serves as a vital lifeline that provides health care coverage to more than 2.3 million low-income Americans with a history of cancer.
“Many cancer patients in active treatment are often unable to work or require significant accommodations to their work schedules due to that treatment. It is unclear from the guidance what standards states would use to define “medically frail.” The unintended consequence may be disadvantaging patients with cancer and serious illnesses. Research suggests between 40 and 85 percent of cancer patients stop working while receiving cancer treatment, with absences ranging from 45 days to six months. Additionally, evidence shows that patients who have recently completed treatment may need additional time to recover and transition back into the workplace.
“We strongly urge CMS to require states exempt people with serious, complex medical conditions, particularly cancer patients and recent survivors from any work requirements. ACS CAN welcomes any opportunity to assist in this process.”
About ACS CAN
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.fightcancer.org.