Jill Biden lauds proposed rule on Medicare payment for cancer navigation services

 July 23, 2023

First Lady Jill Biden – presumably with the full support of her husband, President Joe Biden – stepped forward last week to express her support for a proposal that would see Medicare foot the bill for a potentially expansive menu of cancer patient navigation services, as the Associated Press reports.

Taking part in a conference call with administration officials on the subject, Mrs. Biden declared that the proposed adjustment would make “an enormous difference in people's lives” and therefore had her endorsement.

Proposal lauded by White House

The details of the proposed changes supported by Mrs. Biden were discussed earlier this month by Dr. Danielle Carnival, deputy assistant to Biden for the Cancer Moonshot initiative, who also serves as deputy director for Health Outcomes at the White House Office of Science and Technology Policy.

Carnival articulated what the Centers for Medicare & Medicaid Services (CMS) have proposed, with the White House saying that the changes mark “progress toward Medicare patients benefitting from services and support that help them navigate their cancer journey.”

The administration official further declared, “Thanks to the Biden Cancer Moonshot, the Biden-Harris administration is taking a significant step toward making critical patient navigation services a covered benefit for Americans with Medicare coverage.”

“President Biden and the first lady have long been focused on expanding access to patient navigation services that guide individuals, caregivers, and families as they face a cancer diagnosis, treatment, and survivorship,” she went on. “This proposed rule will help seniors and people with disabilities access the support they need during their cancer journey – support that improves the cancer experience for patients and their families, reduces disparities, and improves health outcomes.”

CMS touts benefits

A press release from CMS on the topic stated that the agency's “proposals in the proposed physician payment rule would help people with Medicare navigate cancer treatment and have access to more types of behavioral health providers, strengthen primary care, and for the first time, allow Medicare payment for services performed by community health workers.”

Meena Seshamani, CMS deputy administrator and director of the Center for Medicare, said, “If finalized, the proposals in this rule ensure the people we serve experience coordinated care focused on treating the whole person, considering each person's unique story and individualized needs – physical health, behavioral health, oral health, social determinants of health, and are inclusive of caregivers....”

According to the release, “In alignment with the goal of the Biden-Harris administration's Cancer Moonshot for everyone with cancer to have access to covered payment navigation services, CMS is proposing payment for Principal Illness Navigation services to help patients navigate cancer treatment and treatment for other serious illnesses.”

As the AP noted, if the proposed rule is finalized, Medicare would have the ability to cover such services, with the adjustments taking effect on Jan. 1 of next year. The public comment period for the proposal runs until Sept. 11.

The first lady weighs in

In signaling her approval of the proposed rule change, Mrs. Biden made reference to her sister, who received stem cell transplant treatments in the past in order to address a lymphoma diagnosis, a process the first lady said also involved the invaluable assistance of a patient advocate.

As such, Mrs. Biden stated that she and her husband have long hoped that such services could be made more widely available and have worked to make that scenario a reality even before his election to the presidency.

“Since we began this work, I've consistently heard one thing: these navigation programs are so successful, but since they aren't generally paid for, most medical practices can't afford to provide them,” the first lady explained.

The Bidens are apparently not alone in their belief that the CMS rule change would be a welcome development, with Dr. Karen Knudsen, CEO of the American Cancer Society and its associated Action Network declaring, “We applaud this first step forward by the administration in recognizing the unique and impactful contributions patient navigators have to improving the outcomes of individuals with cancer and their caregivers,” further opining that “under-resourced or marginalized communities” stand to gain particular benefit from such a move.

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