Sen. Portantino Introduces Legislation to Eliminate Cancer Care Inequity

State Senator Anthony J. Portantino introduced this week Senate Bill 987, the California Cancer Care Equity Act. The measure would address significant disparities in cancer patient access by expanding Medi-Cal patient access to necessary clinical expertise and resources.

“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,” said Sen. 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’s 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, the California Cancer Care Equity Act, will 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. 

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.

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. Patients receiving care from designated specialists saw a 53% reduction in the odds of early mortality, but less than half of California cancer patients received care aligned with national guidelines between 2004-2016. Only about 8% of eligible cancer patients nationally enroll in clinical trials.