Two Portantino Cancer Care Bills Pass Senate Health Committee
For Immediate Release: April 21, 2022
Contact: Lerna Shirinian, (818) 409-0400
Two Portantino Cancer Care Bills Pass Senate Health Committee
Sacramento, CA – Senate Bills 974 and 987, authored by Senator Anthony J. Portantino (D – La Cañada Flintridge) which address the delay and absence of live-saving treatments for cancer patients, passed the Senate Health Committee. SB 974 expands health care coverage for diagnostic breast imaging following an abnormal mammography and SB 987 aims to address significant disparities in cancer patient access by expanding Medi-Cal patient eligibility for necessary clinical expertise and resources.
“SB 974 recognizes the importance of follow up diagnostic testing for breast cancer screenings,” stated Senator Portantino. “Health insurance only covers the initial screening mammogram and does not extend to these crucial follow-up diagnostics, which may save lives and significantly impact health outcomes for women. I am thankful to Gayaneh Pezeshkian Avanes for suggesting this bill idea. Her activism will help thousands of women.”
"I am very excited to cosponsor this bill because I know firsthand the difficulty women must go through to get the necessary tests approved year after year. I either have to fight with my provider to approve the test that could save my life or I need to pay out of pocket to get follow up imaging after the regular mammograms don’t work because of my dense breast tissue," said Assemblymember Cristina Garcia (D-Bell Gardens), who is a principal co-author of the SB 974. "Many women in California, especially women of color, cannot afford any out of pocket expenses for diagnostic testing. And they definitely can't afford the expense for treatment. By removing barriers and giving California women the coverage for breast cancer imaging that they deserve, we are saving the lives of thousands of women and giving them an opportunity to live a long and healthy life."
Breast cancer is the second leading cause of death among women of all races. Early detecting of breast cancer can reduce the risk of dying from the disease by 25-30%. Health insurance coverage extends to mammography screening, which detects 80-90% of breast cancers in women who have not yet manifested physical symptoms. Women who receive abnormal results on a breast cancer screening can be instructed to undergo follow-up testing to ensure that the abnormality is not cancerous, and they are often required to pay out-of-pocket for follow-up testing. This can cause thousands of dollars and cause many women to delay or avoid these appointments and thus delay treatment that can save their life.
SB 974 would require that a health insurance policy, which is issued, amended, or renewed on or after January 1, 2023, must provide coverage for a medically necessary diagnostic breast imaging, including diagnostic breast imaging following an abnormal mammography result. Diagnostic breast imaging includes breast magnetic resonance imaging and breast ultrasound.
“I am grateful to Senator Portantino who listened to my concerns about health care coverage of mammograms and introduced SB 974,” stated Gayaneh Pezeshkian Avanes. “It’s unacceptable that so many women do not go for further testing because of the affiliated costs. When I received a bill from my insurance company for a follow up mammogram, I was surprised to learn it was not covered as part of a preventative visit. SB 974 can make a positive impact on comprehensive preventative care access and allow women receive their preventative (including follow up) exams without the burden paying for it.”
The CDC lists cancer as the second-leading cause of death in California. 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.
“Sadly, there are serious inequalities in access to 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,” stated Senator Portantino. “Health insurance doesn’t guarantee access to experts specializing in complex cancer types, promising clinical trials, and advances in personalized, precision cancer treatments. With advances in cancer science and more effective treatments, it is critical that we ensure all cancer patients have access to new science and technology that can improve health outcomes for patients and their families. SB 987 provides a more equitable model of health care for cancer patients.”
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.
"City of Hope strongly supports the passage of the California Cancer Care Equity Act (SB 987),” said Harlan Levine, President of Strategy and Business Ventures at City of Hope. “Optimal cancer care requires access to the right expertise at the right time to deliver better survival outcomes. The California Cancer Care Equity Act would help Medi-Cal cancer patients access the most highly specialized cancer treatments, clinical trials and care from subspecialists, removing barriers that prevent Californians in underserved communities from accessing optimal cancer care. We applaud the members of the California Senate Health Committee for advancing cancer care equity in California with their support for SB 987.”
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