In January 2011, the State Legislature, recognizing the significant inequity between patients’ copays for oral and self-administered drugs compared to their deductibles for medical benefits for infused drugs, enacted a law to provide equity for these patients. WSMOS had provided comment to DSHS, expressing concerns about potential unintended consequences. Those comments are attached below. Unfortunately they were not addressed in the final bill and we have recently learned of numerous complaints from patients whose insurance companies have informed them that many injectables and some intravenous drugs will be handled administratively under their outpatient medical benefit which will significantly increase their financial responsibility. WSMOS is working with the Washington State Medical Association and other interested parties to have the 2012 session of the Legislature tighten the language of HB 1517 to prevent insurance companies from subverting the intent of the original legislation. We are also working with the Office of the Insurance Commissioner on this issue.

We encourage all oncologists to contact us about instances where your patients have been informed by their insurers that their benefits will be changed beginning January 2012 in contravention of HB 1517.

The actual legislation may be found at:

http://apps.leg.wa.gov/documents/billdocs/2011-12/Pdf/Bills/House%20Passed%20Legislature/1517.PL.pdf