On Wednesday, California Governor Gavin Newsom signed into law the California Cancer Care Equity Act (CCCEA), legislation that will expand access to cancer care for Medi-Cal patients who receive a complex cancer diagnosis. Effective Jan. 1, 2023, the new law will enable the most vulnerable populations in the state to receive optimal cancer care via access to genomic testing, precision medicine-based care, subspecialty expertise, and clinical trials.
“This legislation will make optimal cancer care available to more patients and families in California,” said Robert Stone, CEO of City of Hope and the Helen and Morgan Chu Chief Executive Officer Distinguished Chair. “Governor Newsom is showing the nation how we create a more equitable cancer ecosystem that works better for patients and expands access to lifesaving, leading-edge treatments for those from historically underserved communities.”
The bill, which was introduced in April by state Sen. Anthony Portantino, passed both legislative chambers unanimously and builds off the California Cancer Patients Bill of Rights resolution adopted by the California Legislature last year. Under the new law, sponsor of Medi-Cal managed plans will be required to make a good-faith effort to contract with an NCI-designated comprehensive cancer center, site affiliated with the NCI Community Oncology Research Program (NCORP), or qualifying academic cancer center, within its contracted provider network and its subcontracted provider network for patients with a complex cancer diagnosis. If the plan is unable to do this, it will allow its beneficiaries to seek care out of network.
According to the law, a complex cancer diagnosis is defined as “a diagnosis for which there is no standard FDA-approved treatment or for which known highly effective therapy for metastatic cancer has failed and any of the following diagnoses: hematological malignancies, acute leukemia, advanced, relapsed, refractory non-Hodgkin lymphoma and multiple myeloma, including BPDCN and T-cell leukemias and lymphomas, and advanced stage, relapsed solid tumors refractory to standard FDA-approved treatment options, advanced stage rare solid tumors for which there is no known effective standard treatment options.”
By making this insurance coverage law, the California Cancer Care Equity Act will help remove barriers to leading-edge cancer care for Medi-Cal members, or approximately one-third of the population of the state. Currently, Medi-Cal patients experience worse five-year survival rates across a number of different cancers compared with those who have private insurance. Further, it addresses care inequity as African Americans and Hispanics have the highest rates of Medi-Cal enrollment in California at 44.3% and 44.9%, respectively.
“While there’s more we need to fix in our current delivery system to get the latest innovations to patients equitably or quickly, this is a huge win for patients that will lay the groundwork for additional reforms in the future,” said Portantino, the bill’s sponsor in a press release. “With California home to the most prominent and effective research hospitals in the world, we need to make sure that their efforts reach as many people as possible.”
Not surprisingly, the law has been well received by such organizations as Cancer Care Is Different, a coalition that includes City of Hope, Cedars-Sinai, American Cancer Society Cancer Action Network, Susan G. Komen, The Leukemia & Lymphoma Society, National Marrow Donor Program/Be The Match, California Chronic Care Coalition, North Bay Cancer Alliance, Lazarex Cancer Foundation, Triage Cancer, The Latino Cancer Institute, California Black Health Network, and Stanford Health Care. The coalition was created to raise awareness of the need to improve cancer care delivery in California.
“The Cancer Care Is Different coalition is driven by the belief that the best chance of a cure for a patient is the first chance at a cure: Cancer outcomes uniquely rely on the accuracy and speed of initial diagnosis, choice of therapy and access to appropriate clinical trials,” the coalition stated in a press release. “[CCCEA] is one major step that gives us hope that more Californians will be able to access the care that gives each the best chance to beat cancer, regardless of their insurance or zip code.”