News You Need: A National & State Update on Cancer-Related Legal Issues

2021 has brought a new presidential administration, a new Congress, and new state elected officials. So, we are likely to see many new proposed laws and regulations that may impact the cancer community. Triage Cancer remains committed to bringing you the news that might impact the cancer community.

National News:

  • President Biden is expected to sign an Executive Order today, and based on that Order, “it is expected that” HHS will open for a Special Enrollment Period from February 15, 2021 to May 15, 2021. It is important to note that the 15 states that run their own Marketplaces may or may not follow suit. Stay tuned as we will share more details when they are available.
  • The Internal Revenue Service (IRS) already started to send out second stimulus payments. These payments may be paper checks, direct deposits, or prepaid debit cards. The debit cards are called Economic Impact Payments (EIP) and have the US Treasury seal on the envelope. Beware of scams, but also don’t accidentally throw out this piece of mail! Any prepaid debit cards received during the first round of stimulus payments will not be reloaded. Some people who received a paper check during the first round may receive a debit card this time, and vice versa.Most taxpayers with incomes up to $75,000 ($150,000 for married couples filing jointly) will receive $600 ($1,200 for married couples) and families receive an additional $600 per child under age 17. If you have not received your EIP or have questions, visit the IRS page.
  • Unemployment benefits and the additional $300 per week are extended through mid-March for workers eligible for unemployment compensation. The maximum length of benefits is now 50 weeks through March 14, 2021.
  • The federal rental eviction moratorium is extended through March 31, 2021. The moratorium, issued by the Centers for Disease Control, was previously set to expire December 31, 2020. Renters behind on rent must take action to qualify. Under the moratorium, renters cannot be evicted for not paying their rent if they are below certain income limits and can demonstrate certain hardships. No rent will be forgiven and will become due when the protection ends. Tenants can use this tool to determine if they qualify for the moratorium, which also generates a customized letter that tenants can download or email to their landlords.
    • On January 20, 2021, President Biden asked the Federal Housing Agency to extend protections on foreclosures of federally-guaranteed mortgages that are set to expire at the end of January. Find out who backs your mortgage and what federal COVID-related protections may be available using this tool.
  • Congress acted to ban surprise billing by medical providers. Surprise billing occurs when a patient unknowingly receives care from a provider who is considered out-of-network. The patient can be on the hook for the much higher out-of-pocket costs for seeing an out-of-network provider. This protection begins January 1, 2022. Under the No Surprises Act:
    • Patients who see an out-of-network provider (when going to an in-network facility) will pay the same rate they would have paid for in-network care
      • Applies to emergency and non-emergency care
    • Providers are barred from holding patients liable for higher amounts
    • If insurance company and providers disagree on provider payment rates, they must first negotiate with each other
      • If negotiations fail, the law sets up an arbitration process
    • Patients can get an Explanation of Benefits from their insurance company before receiving care
      • Certain providers can request that the patient sign a consent waiver for the higher cost, but only if the patient knowingly and willingly chooses the out-of-network provider
    • State laws that already ban surprise billing remain in effect
  • The Clinical Treatment Act (CTA) became law, expanding access to clinical trials for Medicaid recipients. Effective January 1, 2022, Medicaid will be required to cover the routine costs of clinical care, like lab tests and doctor visits, that are associated with clinical trials. Most private insurance companies and Medicare are already required to cover these routine costs. Requiring this coverage potentially increases access to clinical trials for the over 40 million recipients of Medicaid. Learn more about clinical trials here:
  • Congress passed the Removing Barriers to Colorectal Screening Act, which corrects a loophole in Medicare coverage that caused unexpected bills for patients when a polyp is removed during a screening colonoscopy. Under the Affordable Care Act, Medicare recipients can get free colonoscopy screenings. But if polyps were removed during the procedure, Medicare treated the colonoscopy as diagnostic, rather than screening, which would increase out-of-pocket costs for patients. The new law phases out these costs gradually until they disappear in 2030.
  • The Families First Coronavirus Response Act (FFCRA) expired December 31, 2020. Under FFCRA, qualified employees could take paid sick leave and paid family leave. As of January 1, 2021, the program became voluntary for employers. See more at the COVID-19 section of
  • Do you have an upcoming hearing with the Social Security Administration (SSA)? The SSA Hearing Offices have been closed to in-person hearings since March 2020. Hearings continued by telephone and now the SSA has a second option, online video hearings. If you choose the video hearing option, you, any witnesses or representatives, and the Administrative Law Judge will be able to see each other to ask questions and testify about your case. You can learn more about this video option here. Note: your local SSA office remains open for telephone and email communication, and limited, pre-scheduled in-person appointments.
  • The Henrietta Lacks Enhancing Cancer Research Act was signed into law on January 5, 2021. The act directs the federal government to study ways to increase access to cancer clinical trial participation among communities that are traditionally underrepresented. Only a small fraction of individuals with cancer enroll in cancer clinical trials due to barriers such as lack of transportation to trial sites, taking time off from work, and increased costs. The act seeks to reduce these barriers and make it easier for patients from diverse backgrounds to enroll in clinical trials. The law honors Henrietta Lacks, who died of cervical cancer in 1951. During her treatment, doctors took samples of her tumor without her knowledge, and a line of those cells have been used to develop treatments for a variety of diseases, including cancer.

State News:

  • Illinois becomes the first state to provide health care coverage to low-income, undocumented seniors. The state Medicaid program serves low-income people 65 and older who are undocumented or have been legal permanent residents – green card holders – for less than five years. Illinois was the first state to provide health care for undocumented children.
    • Income-qualified children, regardless of immigration status, are provided health care in California (through age 25), Illinois, Massachusetts, New York, Oregon, and Washington, D.C.
  • Tennessee received approval to change TennCare, its Medicaid program that covers about 20% of residents, to a block grant program, which caps the funding it will receive from the federal government. It is unclear if the current administration will reverse this approval before it takes effect.


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