The American Cancer Society Cancer Action Network (ACS CAN) recently criticized a new rule from the Centers for Medicare and Medicaid Services (CMS) that will restrict access to special enrollment periods and reduce requirements for Essential Community Providers.
“Under the new rule, patients trying to enroll in insurance plans outside of the annual enrollment period will face strict documentation requirements,” ACS CAN President Chris Hansen said in a news release. “These requirements, while intended to prevent people from inappropriately enrolling in plans, have the potential to delay or interrupt cancer patients’ care. Such patients often face extenuating circumstances due to the nature of their disease and treatment, like job loss or relocation, and rely on special enrollment periods to swiftly transition coverage without interrupting care.”
Hansen noted that the organization supports a stronger marketplace but not at the expense of health insurance access. ACS CAN submitted public comments detailing its concerns with the new rule, but the finalized rule remained mostly unchanged.
“(Weakening) the Essential Community Provider standards and lessening the actuarial value of plans, will likely shift additional costs to patients through higher or more frequent out-of-network charges for various medical services and through diminishing the value of advanced premium tax credits for those who qualify,” Hansen said.
ACS CAN will monitor the changes the rule brings about, he said.