WellPoint, the nation’s largest health insurer by medical membership, plans to unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced in Congress.
Rosa DeLauro
Last month, Rep. Rosa DeLauro (D-Conn.) sent letters to WellPoint, America’s Health Insurance Plans, the Blue Cross Blue Shield Association and other national health insurance companies, urging them to guarantee 48-hour hospital stays to patients with breast cancer who have mastectomies, if they do not already have such a policy in place.
Currently, 20 states have such laws that prevent women being forced to leave the hospital sometimes only hours after surgery, a practice known as a “drive thru mastectomy,” according to DeLauro’s office.
WellPoint said it would implement DeLauro’s provisions July 1. Those provisions include providing more transparent benefit language including clear explanations of benefits to members with breast cancer, and the provisions standardize minimum recovery times in the hospital for women recovering from mastectomy, the insurer said.
While variability exists within clinical guidelines and state regulations, the vast majority of WellPoint’s members already receive the standard of care indicated in the legislation, the insurer said. WellPoint said in a statement it believes that applying this universal minimum standard will both benefit its members, as well as encourage others in the industry to follow and adopt this standard.
DeLauro said that with an estimated 192,370 new cases of invasive breast cancer in women expected this year, ensuring that these patients receive the care they need is essential.
Her bill (HR 1691) seeks to ensure that women who have a mastectomy or lumpectomy for treatment of breast cancer are guaranteed a minimum hospital stay of 48 hours, have access to second medical opinions, and are provided coverage of radiation therapy for those who choose to have a lumpectomy.
DeLauro said the bill ensures that any decision in favor of a shorter or longer hospital stay will be made by the patient and her doctor. Additionally, the bill would make a third-party review process mandatory before an insurance company could impose a rescission, or rescinding, of the insurance policy.
WellPoint, based in Indianapolis, operates as Anthem Blue Cross in Virginia, outside of Northern Virginia, and as Empire Blue Cross in 10 New York City metropolitan and surrounding counties, as well as in several upstate counties in New York. The company, also operates Blue Cross Blue Shield plans in 12 other states.
WellPoint pledges to prohibit need for ‘drive thru mastectomy’ via IFAwebnews .
