Yesterday, the Department of Health and Human Services (HHS) released its 2023 Notice of Benefits and Payment Parameters (NBPP) Final Rule (final 2023 Payment Notice) for Marketplace plans operating on the Federally-Facilitated Exchanges (FFEs), state-based exchanges (SBEs), and state-based exchanges operating on the federal platform (SBE-FPs) in 2023.
The following is a statement from David F. Arons, JD, chief executive officer of the National Brain Tumor Society:
“We’re pleased that HHS has taken important steps in the final NBPP to improve access to care for patients in Marketplace plans. We are especially heartened that HHS recognizes that Marketplace plans should include providers in their networks to best meet the needs of the populations they serve. We believe these are moves in the right direction in helping to improve access to specialized care for cancers such as brain tumors. We look forward to working with HHS to help strengthen access to specialized treatment centers for cancer care in Marketplace plans.
Brain tumor patients need specialized medical services from the very beginning of their disease journey through survivorship or end of life in the form of diagnostic, medical, rehabilitative, psychosocial, and palliative care. They also need access to clinical trials and next generation genomic sequencing. Access to adequate and affordable specialty care is essential for brain tumor patients. Medically, neuro-oncology is a subspecialty of oncology, neurology, and neurosurgery and is heavily reliant upon pathology and radiology. This level of care is available in the National Cancer Institute’s Designated Cancer Centers (NCI DCCs), yet currently, many Marketplace plans do not include NCI DCCs in their networks.
While the final rule marks an important first step, we believe that ultimately more will need to be done to assure access to high-value services for brain tumor patients in the implementation of the Patient Protection and Affordable Care Act (ACA) and the supporting regulations. Several issues of network adequacy still need to be addressed, while others must be strengthened to meet the unique needs, promote quality of care, and improve outcomes for brain tumor patients. We look forward to continuing to work with HHS and the Administration on efforts to ensure QHPs offer these vulnerable patients the right care at the right time and that there is equity in coverage.”
Building on over 30 years of experience, the National Brain Tumor Society (NBTS) unrelentingly invests in, mobilizes, and unites the brain tumor community to discover a cure, deliver effective treatments, and advocate for patients and caregivers. Our focus on defeating brain tumors and improving the quality of patients’ lives is powered by our partnerships across science, health care, policy, and business sectors. We fund treatments-focused research and convene those most critical to curing brain tumors once and for all. Join us at braintumor.org.