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During the unprecedented COVID-19 crisis, there are policies that must be changed or temporarily suspended to help ensure that cancer patients have access to both the medications and treatments they need. That is why the Colorectal Cancer Alliance has joined with the American Cancer Society, the Coalition to Improve Access to Cancer Care, and other cancer groups in urging Congress and the Department of Health and Human Services (HHS) to enact critical policy changes. These include:

Suspend network requirements. Cancer patients may not be able to access treatment at the facility that is in their health insurance network because it has temporarily closed or had to prioritize virus treatments. Patients should not have to pay out-of-network cost sharing because of the COVID-19 virus. We are calling on HHS to direct that all federally regulated plans suspend network requirements during the pandemic so that if the in-network facility or doctor is not available, cancer patients can obtain treatment out-of-network without a cost penalty.

Allow 90-day medication fills and refills. As mandated in the Coronavirus Aid, Relief, and Economic Security Act (CARES), Congress requires that Medicare and all Medicare Advantage plans allow patients to fill or refill prescriptions for up to 90 days during the COVID-19 crisis. Reducing the frequency of vulnerable patients needing to visit the pharmacy, or additional trips by delivery staff, makes sense during this lock down period. HHS should expand this requirement to provide the same protection within all federally regulated plans.

Home infusion. The Centers for Medicare & Medicaid Services (CMS) has taken action to facilitate home infusion for drugs administered through Medicare Part B. This offers the benefits of reducing treatments in facilities dealing with COVID-19 patients, as well as eliminating exposure of patients with reduced immune capacity to these facilities. However, the Colorectal Cancer Alliance contends that a cancer patient’s health and safety must be the first priority. We urge HHS to allow doctors and their patients to make a medical decision on home infusion and that this not be federally mandated.

Oral chemotherapy. At any time, but particularly during a pandemic when our health care system is overwhelmed, it makes no sense that cancer patients prescribed oral drugs pay a much higher co-pay than if they were prescribed IV chemotherapy. To address this, many states have passed legislation that prohibits charging higher co-pays for oral anti-cancer drugs than IV chemo. However, patients on federally regulated plans continue to face this unequal payment structure. The Colorectal Cancer Alliance is supporting The Cancer Drug Parity Act which would prohibit health plans from having unequal cost-sharing arrangements between oral and IV chemo. We urge Congress to include this as it moves forward broad legislation to address the COVID-19 crisis.

Find and contact any of your elected representatives on these issues here.


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