Ensuring Access to Cancer Navigation Services in Texas


The LIVESTRONG Foundation has been providing cancer navigation services for more than 10 years.  The concept of patient navigation was pioneered by one of our board members, Dr Harold Freeman, in Harlem, New York, in the early 1990s.

At the LIVESTRONG Cancer Navigation Center in East Austin we provide free, confidential, one-on-one support to patients and families affected by cancer.  These services are provided in English and Spanish and include everything from emotional support, clinical trials access, fertility preservation services, help with treatment options, financial counseling and insurance issues.  Our services can be accessed in person in Austin and also across the United States by phone (855) 220-7777 or online (www.livestrong.org/we-can-help).


Recently, the Texas Department of Insurance (TDI) proposed regulations affecting navigators for Affordable Care Act (ACA) health benefit exchanges.  The proposed regulations required 40 hours of additional training for ACA navigators and imposed registration fees for each navigator.  The proposed regulations would also have prohibited organizations from using the term “navigator” unless they are registered with the state of Texas.

The primary focus of LIVESTRONG cancer navigators is not to enroll people in insurance plans under the Affordable Care Act.  Their main purpose is to help people and families navigate a difficult cancer experience.  At the same time, we felt that these proposed regulations were an unfair burden on organizations like ours as we work to help people and families living with cancer.

The LIVESTRONG Foundation submitted written testimony to the Texas Department of Insurance on the impact that these proposed regulations could have on the support services we provide.  We know that many other lawmakers and health organizations across the state expressed similar concerns.

This week, the Texas Department of Insurance issued the final regulations and we were pleased that the Department made some important changes.  TDI lowered the state navigator training requirement from 40 hours to 20, waived the $50 registration fee for each navigator and clarified the language prohibiting the use of the term navigator.

While we are pleased that TDI made these improvements, we still have general concerns that these rules place additional burdens on ACA navigators who are trying to enroll individuals in the exchanges.  While TDI reduced the required training hours and eliminated registration fees for ACA navigators in the state of Texas, we believe that the 20 hours of training required under the ACA is sufficient.

Dealing with a cancer diagnosis is difficult enough for patients and families.  When additional regulations and barriers are added, it can make it more difficult for the people who desperately need these navigation services to receive them.  The LIVESTRONG Foundation is committed to continuing our advocacy work to ensure that all patients and families living with cancer have access to the services they need.

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