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An Update on Healthcare Legislation at the State Level

By Christian G. Downs, MHA, JD

March 22, 2023
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As we all know, Congress, the White House, and the Centers for Medicare & Medicaid Services (CMS) drive many of the issues and conversations around policy change in healthcare each year. While several key issues are being discussed in DC, including 340B reform, co-pay accumulators, and affordability issues, most of these efforts will be mired in the slow process of Congressional decision-making.

However, if you are looking for legislative action, look no further than state legislatures. Most—if not all—states have had issues relating to oncology care and healthcare in general come up during their 2023 sessions. And it is more important now than ever before to get involved in your state’s advocacy work to protect your cancer program or practice and the high-quality cancer care patients deserve.

Co-Pay Accumulators, White Bagging, 340B, & Prior Authorizations

Many states are looking to ban or limit the use of co-pay accumulators and maximizers. This is a positive movement for patients with cancer, as these tactics have been increasingly used by payers to maximize their payments and has no impact on increasing patient affordability. There are also states that are discussing bans on white bagging—the practice of requiring patients’ medications to be sent to a specific specialty pharmacy for dispensing and shipped directly to the cancer program or practice for administration, which impacts the integrity of the product once patients present for their treatment. Further, 340B reform is on the table in several states, as is the topic of reigning in prior authorization. These issues are important to the multidisciplinary cancer care team, and it is vital that locally elected officials truly understand the impact they have on their constituents.

Why You Should Get Involved 

Getting involved at the state level is easy. The Association of Community Cancer Centers (ACCC) and many of its oncology state societies are helping its members with having their voice be heard. ACCC's Legislative Action Center currently has a number of state-level bills the association is tracking online that members can advocate for using personalized letters, which can be sent automatically to user’s elected officials. In addition, several of ACCC’s oncology state societies (i.e., the Empire State Oncology Hematology Society, Texas Society of Clinical Oncology Society, North Carolina Oncology Association, and Tennessee Oncology Practice Society) have participated in grassroots advocacy efforts, from letter writing campaigns and testifying before legislative committees to meeting with members of local legislatures during official or unofficial cancer action days.

The American Cancer Society Cancer Action Network (ACS CAN) has been especially busy in over a dozen states with its efforts to pass biomarker testing coverage laws. ACCC and local groups like the Rocky Mountain Oncology Society, Arizona Oncology Clinical Oncology Society, and Missouri Oncology Society have partnered to advocate for specific legislation and host cancer action days.

If you want to get more involved, first visit the ACCC Legislative Action Center to see if there are any bills the association is tracking in your state. Also, visit your oncology state society’s website to see if it is supporting any local initiatives and how you can get involved. Finally, visit the ACS CAN website to see if there are any cancer action days happening soon in your state.

Christian G. Downs, MHA, JD, is the executive director at ACCC.

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