FROM THE JOURNAL OF CLINICAL ONCOLOGY

Oncologists are calling for better coverage of cancer screening and treatment for Medicaid patients, including coverage of screening without copays, parity of cancer treatment payments for physicians between Medicare and Medicaid, better access to clinical trials, and coverage for oral therapies as exempt services for cost-sharing purposes.

The policy recommendations, issued by the American Society of Clinical Oncology were published Nov. 17 online in the Journal of Clinical Oncology (2014 Nov. 17 [ doi:10.1200/JCO.2014.56.3452 ]).

“Clear barriers exist for Medicaid beneficiaries for accessing high quality and timely medical care,” Dr. Michael Halpern of the University of Arizona in Tuscon, coauthor of the policy recommendations, said during a press briefing.

The policy recommendations are based on four guiding principles:

 No individual diagnosed with cancer should be without health insurance that guarantees access to high-quality care delivered by an oncologist.

 Medicaid patients should receive the same timely, high-quality care as patients with private insurance.

 Medicaid payments should ensure patients have access to timely, high-quality care.

 Medicaid patients should not face insurance barriers when it comes to clinical trial participation.

Physician payment recommendations include the elimination of variations between Medicare and Medicaid in terms of physician payment, the improvement of cancer treatment quality measures that can be ties to flexibility in operating state Medicaid programs, and allowing oncology practices to serve as medical homes and expand reimbursement for care coordination and patient education.

Other policy recommendations include allowing Medicaid patients to cross state lines for clinical trial participation and extending clinical trial protections in the Affordable Care Act to Medicaid patients, improving the 340B program to ensure it is operating as designed. The American Society of Clinical Oncology also wants to see Medicaid expansion in all 50 states.

gtwachtman@frontlinemedcom.com

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