Increased Access to Cancer Care Needed in Medicaid, CHIP, Other Programs

July 5, 2023

The Association for Clinical Oncology (ASCO) continues to advocate for increased access to cancer care and improved health equity for Medicaid beneficiaries and Deferred Action for Childhood Arrivals (DACA) recipients. In three recent comment letters, ASCO applauded proposals to improve access to high-quality, equitable cancer care and made important recommendations regarding the agency’s plans to expand health care coverage to more people.

In one comment letter, ASCO applauds the Centers for Medicare & Medicaid Services (CMS) for its proposal to extend Medicaid, Children’s Health Insurance Plan (CHIP), Basic Health Program (BHP), and Affordable Care Act Marketplace (Marketplace) coverage—thereby improving access to cancer care—to approximately 120,000 previously uninsured DACA recipients. Extending coverage to these individuals will help ensure access to care for individuals with a cancer diagnosis, promote screening and preventative cancer services, and advance health equity.

In comments on a proposed rule addressing beneficiary access to care under Medicaid fee-for-service (FFS) plans, ASCO supports requiring states to establish and maintain a beneficiary advisory group that would offer direct input to the Medicaid Advisory Committee (MAC) on issues related to health and medical services, policy development, and effective administration of the Medicaid program. Effective implementation of such advisory committees will aid in identifying and addressing barriers to high-quality, equitable cancer care.

ASCO also supports CMS’ proposal to make FFS payment rates publicly available, but it does not support Medicaid provider payments that are less than the Medicare payment. CMS’ proposal acknowledges that insufficient Medicaid provider payments jeopardize beneficiary access to care by limiting the number of providers who accept Medicaid patients. ASCO urges CMS to require states that do not establish a minimum Medicaid payment rate equivalent to the Medicare rate to complete an access review and ensure that beneficiaries are not at risk of reduced access to cancer care services.

In comments on beneficiary access in Medicaid Managed Care plans, ASCO reiterated its view that Medicaid physician reimbursement should not be less than what Medicare pays for the same service. Additionally, CMS requested input on other barriers to physician participation in Medicaid, and ASCO highlighted the extreme burden prior authorization places on physicians and how prior authorization can prevent timely access to services for Medicaid enrollees. ASCO urges CMS to adopt the recommendations in the American Society of Clinical Oncology’s, Position Statement on Prior Authorization.

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