SB 987, authored by Sen Anthony J. Portantino (D – Pasadena) which addresses significant disparities in cancer patient access by expanding Medi-Cal patient eligibility for necessary clinical expertise and resources, passed the senate floor earlier this week.
“Sadly, there are serious inequalities in access to state of the art care for cancer patients. The impact of these care disparities is greater for patients who are Medi-Cal beneficiaries, especially those who come from underserved communities,” Portantino said in a prepared statement. “The California Cancer Care Equity Act will be a major milestone in improving access to care and reducing disparities in cancer outcomes. We’ve seen incredible innovation in cancer treatments over the past decade, and it is vital that we take a close look at how we deliver innovations in care to equitably reach patients. With the Senate passage, we are moving forward with expanding access to leading-edge treatments for Medi-Cal patients, and I am hopeful that the Assembly will now help us to continue this important work.”
The CDC lists cancer as the second-leading cause of death in California. Health insurance doesn’t guarantee access to experts specializing in complex cancer types, promising clinical trials, and advances in personalized, precision cancer treatments. More than 187,000 Californians are diagnosed with cancer every year, and thousands of them will be misdiagnosed or placed on inappropriate or ineffective treatment.
SB 987, the California Cancer Care Equity Act, which also passed the Senate Health Committee, aims to improve cancer care access, cancer care outcomes (i.e., survival), and patient experience by enhancing Medi-Cal patient access to necessary clinical expertise and resources at NCI-Designated Comprehensive Cancer Centers. The bill parallels the current Medi-Cal coverage model that allows Medi-Cal beneficiaries to have access to certain life-saving care services at a Center of Excellence, even if that center is not included in the member’s provider network. Specifically, SB 987 expands the existing set of care diagnoses for which such enhanced access is provided and includes clinically necessary cancer care services such as genomic/genetic/transcriptomic/proteomic testing, clinical trials participation, and all necessary cancer-related outpatient and inpatient clinical care, defined episode of care.
SB 987 would also require Medi-Cal managed care providers to inform enrollees of their eligibility to receive enhanced care and ensures primary care doctors in contract with those managed care providers inform enrollees with any information they need to decide between relevant treatment options. The bill also requires that decisions to approve, deny, or modify a patient’s request for optimal care are made within a 72-hour time window to shorten the window between diagnosis and treatment.