Medicaid Block Grant Proposal Would Harm Patients with Cancer in Tennessee

January 21, 2020

The Tennessee Oncology Practice Society (TOPS) and the American Society of Clinical Oncology (ASCO) sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, outlining concerns about Tennessee’s proposal to transition its current Medicaid program to a block grant approach.  

TOPS and ASCO fear that this proposal will harm an already vulnerable population of patients and practices in a largely rural state by hindering access to high-quality cancer care. 
 
In particular, the organizations raised concerns around:

  • Re-enrollment lockouts: Proposed lockouts would result in disruptions in care, unanticipated treatment delays, and delays in screening for patients at an increased cancer risk.
  • Restrictive formulary: Proposals to implement a restrictive formulary with as few as a single drug per therapeutic class is a significant concern for continued access to appropriate treatments for people with cancer.
  • Provider reimbursement: Proposed exemptions from CMS’ reimbursement rate requirements could cause further harm to struggling practices and providers and reduce patient access to care.
  • Essential health benefits: Proposed exemptions from CMS’ requirement that covered benefits must be the same for all covered populations threatens to restrict access to screening and preventative services and/or limit therapy options. 

"Cancer patients represent a special population that should be largely exempt from regulations intended to restrict access or limit therapy options, in recognition of the unique nature of the disease, its treatment, and its potentially lifelong impact,” the organizations write.

Read the full letter.

Visit ASCO in Action for updates on state and federal Medicaid programs, and learn more about Medicaid waivers from ASCO’s position statement on Medicaid waivers and their impact on cancer care.