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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HHS Secretary Kathleen Sebelius on WellPoint's Decision to Ban Rescissions in Advance of the Affordable Care Act's Requirement

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released the following statement today on WellPoint's announcement that it intends to end the practice of rescinding patients' coverage in advance of the Affordable Care Act's requirement that insurers stop this practice starting this fall. WellPoint's announcement comes after Secretary Sebelius sent a letter on April 22 urging the company to immediately stop the practice of rescinding coverage for patients who become ill.

The Affordable Care Act will specifically prohibit insurance companies from rescinding policies, except in cases of fraud or intentional misrepresentation of material fact.


STATEMENT OF SECRETARY SEBELIUS

"Last week, when I heard reports of one insurer - WellPoint - targeting breast cancer victims for rescission of their policies, I challenged the company and the rest of the insurance industry to do what they have done with other key insurance reforms in the bill and not wait until September to do the right thing.

The last thing someone who is really sick needs to hear is that they are being dropped by their insurer because they got sick and tried to use the policy they purchased.

I was encouraged to learn today that WellPoint has announced it will act to stop rescissions and no longer engage in this practice as of the end of this week. I urge other insurers to also accelerate the Affordable Care Act's deadline for ending this practice and stop rescinding patients' policies immediately."

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