Wednesday, May 26, 2010

Blue Cross and Blue Shield of Georgia Announces It Will Unilaterally Implement Key Provisions of the 'Breast Cancer Patient Protection Act'

/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) announced today it will unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced by U.S. Representative Rosa DeLauro. These new provisions include 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 adoption of these provisions builds on BCBSGA's existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of BCBSGA's members already receive the standard of care indicated in the legislation. However, BCBSGA believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, BCBSGA will standardize clinical guidelines for women recovering from mastectomy, and will continue to offer a voluntary 48-hour minimum in-hospital stay.

"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Robert McCormack, Medical Director, BCBSGA. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that BCBSGA continues to lead in this area," he added.

"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments that will shape improvements in care for women diagnosed and living with breast cancer, or who are in remission," said McCormack. "Our goal is to ensure that our members receive optimal care."

BCBSGA also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, BCBSGA is taking steps to provide more straight-forward explanations of benefits so that members more clearly understand their treatment options.

"BCBSGA works diligently to ensure that all of our members are getting best practice care," said Monye Connolly, President, BCBSGA. "We are especially proud of our record in improving care for women with breast cancer and believe these added measures will increase the quality of care that our members receive."

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Blue Cross and Blue Shield of Georgia's New Medicare Supplement Plans Offer More Choice and Financial Flexibility to Georgia's Growing Medicare Population

/PRNewswire/ -- Today Blue Cross and Blue Shield of Georgia (BCBSGA) introduced new "modernized" Medicare Supplement plans that have been updated to consider the needs of today's Medicare beneficiaries.

BCBSGA's new Medicare Supplement plans will offer a portfolio of options ranging from comprehensive coverage that bridges Medicare gaps, to the availability of packages offering affordable monthly premiums and more predictable copayment structures that encourage wellness by making doctor's visits more affordable for beneficiaries. Consumers in Georgia can select from five plans: A, F, High deductible F, G and N with an effective date of June 1, 2010.

"The updates to the Medicare Supplement health benefit plans are welcome news for Medicare beneficiaries during these tough economic times because the plans align the benefits with the recent updates made to the Medicare program," said Krista Bowers, president of BCBSGA Senior Business. "The new 'modernized' Medicare Supplement plans offer peace of mind, practicality and affordability that is in tune with today's Medicare landscape."

The new Medicare Supplement plans are a result of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 that authorized a new set of Medicare Supplement insurance plans to reflect the needs of today's Medicare beneficiaries.

A Medicare Supplement policy (sometimes referred to as Medigap) is a supplemental health insurance plan sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medicare Supplement policies help pay some of the health care costs that the Original Medicare Plan doesn't cover. If an individual is enrolled in the Original Medicare Plan and has a Medicare Supplement policy, then Medicare and Medicare Supplement will pay both their shares of covered health care costs. BCBSGA and its affiliated health plans are among the largest providers of Medicare Supplement health plans in the nation.

Although as of June 1, 2010 the current Medicare plans referred to as "standardized" plans will no longer be open for new sales or new membership, Medicare beneficiaries who are currently enrolled in a "standardized" or "pre-standardized" Medicare Supplement plan can retain their current plans as long as their premium payments are current.

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WellPoint Announces It Will Unilaterally Implement Key Provisions of the 'Breast Cancer Patient Protection Act'

/PRNewswire/ -- WellPoint, Inc. (NYSE:WLP) , the nation's largest health insurer by medical membership, announced today it will unilaterally implement key provisions of the Breast Cancer Patient Protection Act introduced by U.S. Representative Rosa DeLauro. These new provisions include 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 adoption of these provisions builds on WellPoint's existing leadership in breast cancer treatment. 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. However, WellPoint believes that applying this universal minimum standard will both benefit our members, as well as encourage others in the industry to follow and adopt this standard. Beginning July 1, 2010, WellPoint will standardize clinical guidelines for women recovering from mastectomy to offer a voluntary 48-hour minimum in-hospital stay.

"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," said Sam Nussbaum, Chief Medical Officer, WellPoint. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that WellPoint continues to lead in this area," he added.

"We continue to work with the American Cancer Society and academic thought leaders to gain real-world knowledge of breast cancer treatments to shape improvements in care for women with breast cancer," said Nussbaum. "Our goal is to ensure that our members receive optimal care."

WellPoint also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates work with members daily, to encourage detection of breast cancer at its earliest stages and to ensure that members are receiving the best breast cancer treatments available. Toward that end, WellPoint is taking steps to provide comprehensible, straight-forward explanations of benefits so that members more clearly understand their treatment options.

"WellPoint works to ensure that all of our members are getting best practice care," said Dijuana Lewis, Chief Executive Officer of WellPoint's Comprehensive Health Solutions business unit. "We are especially proud of our record in improving care for women with breast cancer in this country and believe these added measures will increase the quality of care that our members receive."

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Wednesday, May 05, 2010

Secretary Sebelius on New Benefits for Companies and Early Retirees in the Affordable Care Act

The U.S. Department of Health and Human Services today issued regulations establishing the Early Retiree Reinsurance Program in the Affordable Care Act. This temporary program will make it easier for employers to provide coverage to early retirees. You can find more information about this important new program at http://www.whitehouse.gov/the-press-office/fact-sheet-early-retiree-reinsurance-program.

Rising costs have made it hard for employers to provide quality, affordable health insurance for workers and retirees,” said Secretary Sebelius. “As a result, many Americans who retire before they are eligible for Medicare are worried about losing health insurance coverage through their former employers, putting them at risk of losing their life savings due to medical costs. This new program will provide much-needed relief so that employers can provide more retirees with quality, affordable insurance, starting this year.”

The percentage of large firms providing workers with retiree coverage has dropped from 66 percent in 1988 to 31 percent in 2008. The Affordable Care Act includes $5 billion in financial assistance to employers to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare. The program will end in 2014, when Americans will be able to choose from additional coverage options through the health insurance exchanges.

Eligible employers can apply for the program through the Department of Health and Human Services. Applications will be available by the end of June. Both self-funded and insured plans can apply, including plans sponsored by private entities, state and local governments, nonprofits, religious entities, unions, and other employers.

If you want to learn more about how this new benefit could affect you and your company or your family member who is considering early retirement, tune into the next Affordable Care Act web chat at healthreform.gov.

Secretary Sebelius and Department of Commerce Secretary Gary Locke will host a web chat on the new Early Retiree Reinsurance Program Wednesday, May 5, at 11:30 A.M. EDT at www.healthreform.gov

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