Archive for the ‘Legislative’ Category

TAKE ACTION: Save Federal Protections for People with Pre-existing Conditions like Breast Cancer

Posted By on May 31st, 2017 at 9:32 am | 0 comments.

The U.S. House of Representatives in Washington recently voted to repeal and replace the Affordable Care Act, also known as Obamacare, and to replace it with a new law. The bill that passed the House of Representatives, called the American Health Care Act, also known as Trumpcare, removes federal health insurance protections for people with pre-existing conditions like breast cancer. Instead, individual states would be able to create high-risk pools which did not work in the past and will not work now. That means, if you have a pre-existing condition like breast cancer, you may be denied health insurance or charged more for your care.

We cannot let that happen.

The bill is now in the U.S. Senate. We have reached out to both U.S. Sen. Bob Casey and U.S. Sen. Pat Toomey to find out where they stand on federal health insurance protections for people with pre-existing conditions like breast cancer. Sen. Casey has committed to saving federal protections for people with pre-existing conditions. Sen. Toomey has not taken a public position yet, but his office says he “will ensure affordable coverage for those with chronic conditions.”

Will you help us save federal health insurance protections for people with breast cancer?
Here’s what we need you to do:

Thank YOU for your passion and determination on this important issue. Together, we can make a difference for people with pre-existing conditions like breast cancer. Take action. Save lives.

 

Advocating for You: PBCC Committed to Saving Federal Insurance Protections for People with Pre-existing Conditions

Posted By on May 16th, 2017 at 2:54 pm | 0 comments.

The PA Breast Cancer Coalition represents hundreds of thousands of breast cancer survivors and their families across the state. For that reason, we need to tell you about something important happening right now in our country that will affect you, your family and your health insurance.

Recently, the U.S. House of Representatives voted to pass the American Health Care Act, also known as Trumpcare. This bill would repeal and replace the current Affordable Care Act, which is also referred to as Obamacare. If that happens, we will no longer have FEDERAL health insurance protections for people with pre-existing conditions like breast cancer. Instead, the decision to cover or not cover pre-existing conditions would be left to individual states. States can put people with pre-existing conditions into “high-risk pools” where insurance companies can charge people more money for health insurance, if they are covered at all. We had high-risk pools before and they did not work.

We cannot let this happen for breast cancer survivors and others with pre-existing conditions. It could mean the difference between life and death.

We want to thank the Pennsylvania congressmen who voted against the bill which removed federal health insurance protections for people with pre-existing conditions. That bill is called the American Health Care Act (AHCA) / Trumpcare.

Where is your congressman on this list?   Click here to find YOUR congressman

Now, the bill is in the U.S. Senate. U.S. Senator Bob Casey has said he would vote NO on any bill that removes federal health insurance protections for pre-existing conditions and, in January, introduced his own amendment protecting Pennsylvanians with pre-existing conditions like breast cancer. U.S. Senator Pat Toomey has not yet taken a position on whether to save federal coverage for people with pre-existing conditions.

U.S. Senator Bob Casey Hosts PBCC Roundtable Calling for Medicare Coverage of Lymphedema Supplies

Posted By on February 2nd, 2017 at 11:30 am | 0 comments.

P1000580Pennsylvania breast cancer survivors who suffer from lymphedema shared their personal stories and struggles with the U.S. Senator Bob Casey during a roundtable Friday, January 27, 2017. Together, they are fighting for Medicare coverage of lymphedema supplies like garments and sleeves.

Stage III breast cancer survivor Jeanne Schmedlen of Lemoyne (pictured in the photo on the left) lives with the condition every day. She brought her mechanical compression garment to share P1000702with the Senator and explain the high costs associated with lymphedema maintenance.  Survivor Peggy Grove of Harrisburg (picture on the right, next to Jeanne) has spent tens of thousands of dollars out-of-pocket on sleeves, gauntlets and machines to care for her lymphedema.

Brenda Mitchell of Philadelphia (pictured on the right with Sen. Casey) also shared her story during the roundtable. She took part in a year-long clinical trial during which she was given supplies for her lymphedema.  Now that the trial is over, Medicare will not cover the high costs for her garments.

 

 

 

 

From the desk of: PA Rep. Matt Baker

Posted By on October 17th, 2016 at 3:53 pm | 0 comments.

rep-baker-headshot-for-plHouse Health Committee Chair sheds light on what Breast Cancer Awareness Month means to him

This past year I was humbled and honored to receive the PA. Breast Cancer Coalition Pink Ribbon award, their highest award, and dedicate it to my sister-in-law fighting a rare form of inflammatory breast cancer.

Every woman who conquers breast cancer has an amazing story to share of their journey.  The one common thread in every story is that early detection saves lives.  October is “Breast Cancer Awareness Month,” and it’s hard to forget with pink ribbons, ties, and professional athletes wearing pink.

The statistics bear repeating.  One in eight women in the United States will be diagnosed with breast cancer in her lifetime.  Breast cancer is the most commonly diagnosed cancer in women and is the second leading cause of cancer death among women.  Each year, more than 246,660 women and 40,000 men will be diagnosed with breast cancer in the nation.

One statistic that is trending in a positive direction is the number of people – 2.8 million – who are breast cancer survivors.  They are living full lives after having been diagnosed.

Pennsylvania is making strides in the continued effort to support those who have been diagnosed with breast cancer.  The Breast Density Notification Act requires mammography providers to notify women categorized as having dense breast tissue and about their condition.  Knowledge is power and this law has improved detection and prevention by educating patients about dense breast tissue and how it could conceal possible abnormalities during mammographic procedures.

Three-dimensional mammograms were approved by the Food and Drug Administration five years ago.  In 2014, the American College of Radiology declared tomosynthesis, the medical term for three-dimensional mammography, to no longer be a mere investigational tool.  Pennsylvania followed up last year by becoming the first state to require insurers to cover all screening mammograms, including the 3-D versions, at no out-of-pocket cost to consumers.  To see a list of the mammography facilities that offer 3D mammograms in Pennsylvania, please visit the Pennsylvania Breast Cancer Coalition’s website at pabreastcancer.org

In July Pennsylvania became the 42nd state to provide patients equal access to anti-cancer treatments with the enactment of oral chemotherapy legislation (Act 73 of 2016).  I was proud to author the enabling Oral Chemo Parity Legislation (House Bill 60).

Chemotherapy can have a violent effect on the human body as it does its job.  Oral chemotherapy drugs are often as strong as those administered intravenously and may have fewer side effects.  In some instances, oral medications are the only form of chemotherapy a patient can handle.

There is also the financial impact.  Prior to Act 73, orally-administered chemotherapy was covered under a health plan’s pharmacy benefit, which required patients to pay a percentage of the total cost of the drug (generally between 25-30 percent).  This created an enormous financial barrier for patients to access these drugs prescribed by their cancer physician for treatment.  Act 73 prohibits insurance policies from placing oral anti-cancer medications on a specialty tier or charging a copay for the medication.

Hopefully, these measures will help in saving lives and make treatment of breast cancer more tolerable and successful.  The end goal is to eradicate this disease.  Continued support of innovative and high-impact research will someday hopefully lead to the cure.

In Depth: PA’s Oral Parity Law for Cancer Treatment

Posted By on September 1st, 2016 at 9:31 am | 0 comments.

oral parity law for PL with logo 2Guest author: Kim Kockler, Independence Blue Cross

On July 8, 2016, House Bill 60 was signed into law by Governor Wolf as Act 73.  The legislation requires health insurance companies to provide coverage for oral chemotherapy medications or impose cost sharing on a no less favorable basis than intravenous (IV) or injected chemotherapy medications for cancer patients. The new law is intended to establish a level of parity for patients regardless of the type of cancer chemotherapy medication they are being prescribed – oral medication or injected medication. It is important for consumers to understand the practical implications of the new law. The following are some points to keep in mind:

•    The legislation applies only if a health insurance policy already includes coverage for IV or injected chemotherapy medications that are FDA-approved.

•    Under the law, insurers are prohibited from increasing cost sharing for chemotherapy medications for the purpose of avoiding complying with the law. Cost sharing examples include a co-payment, coinsurance or other out-of-pocket expense a consumer may have as required under their health insurance policy.

•    Oral chemotherapy medications may be subject to a health insurance plan’s prior authorization requirements. This means that the health insurance plan may require the provider who is treating the patient to get prior approval from the health insurance company before medication is dispensed to the patient. The law allows the health insurance company to consider both the medical necessity and cost of the oral chemotherapy medication in comparison to IV or injected chemotherapy medication when making a prior authorization determination.

•    The specific number and type of oral chemotherapy medications that are covered may vary by insurer and type of health plan.

It is also important to note which types of health insurance plans fall under the new law and the effective date. Act 73 applies to health insurance plans purchased by individuals as well as fully-insured small and large group plans offered by employers. The Act does not apply to self-funded plans. For those with insurance provided by their employer, it is best to check with the employer to inquire if the health insurance plan is self-funded.

The new law is effective for plans issued or renewed on or after January 8, 2017 for fully-insured large group health plans.  For individual and small group plans, Act 73 is effective on or after January 1, 2018.
It is recommended that consumers check with their health insurance company to determine specifically how the new law applies to their particular coverage.

First in the Nation: Governor Wolf Signs Statement Covering 3D Mammograms in PA

Posted By on August 16th, 2016 at 10:15 am | 0 comments.

Pat and Governor Wolf rounded cornersOn October 5, 2015, Governor Tom Wolf made Pennsylvania the first state in the nation to require insurance coverage of 3D screening mammograms for women insured under PA law. First Lady Frances Wolf made the historic announcement almost one year ago at the PA Breast Cancer Coalition Conference in Harrisburg. Now, 3D screenings mammograms are covered at no additional cost to insured women and women covered through Medicaid.

To mark the 1st anniversary of the groundbreaking news, the PBCC is informing women across the state about how to access 3D screening mammograms in their area. We’ve launched a 1-question survey of all mammography centers. At our Conference October 10, we will release a list of the Pennsylvania 3D mammography centers. The list will also be published on our website, in our Frontline newsletter and right here in PinkLink.

Do you work for a mammography center that offers 3D screening mammograms? Don’t miss the list! Take the survey now and make sure your facility is listed as a 3D mammography provider.

Take the survey button

Governor Wolf Signs Bill Covering Oral Cancer Treatment for PA Patients

Posted By on July 14th, 2016 at 9:43 am | 0 comments.
PBCC Director of Patient Advocacy Dolores Magro spoke with oral chemo parity bill author Rep. Matt Baker at a recent press conference held by the PA Cancer Treatment Fairness Coalition at the State Capitol.

PBCC Director of Patient Advocacy Dolores Magro spoke with oral chemo parity bill author Rep. Matt Baker at a recent press conference held by the PA Cancer Treatment Fairness Coalition at the State Capitol.

Governor Tom Wolf just signed a bill that helps with the high costs of oral cancer treatment for patients in Pennsylvania. Rep. Matt Baker’s House Bill 60 specifically addresses the cost disparity between intravenous and oral cancer treatments. Previously, oral cancer medication was covered under an insurer’s pharmacy (drug) benefit, often requiring patients to pay thousands of dollars per month, out-of-pocket. Now, oral treatments will be covered the same as intravenous medications on an insurer’s medical benefit, which means patients will only be required to make a fixed co-payment.

Rep. Baker, a 2015 PBCC Pink Ribbon Awardee, authored the oral cancer treatment parity bill and has been working to pass the legislation for years. The following legislators were also instrumental in the passage of the bill: Sen. Tommy Tomlinson, Senate sponsor of oral cancer treatment parity legislation, Sen. Pat Vance, chair, Senate Health and Public Welfare Committee, Sen. Don White, chair, Senate Banking and Insurance Committee and Rep. Kerry Benninghoff, chair, House Cancer Caucus.
“This legislation was a long time in coming. With more than 80,000 people per year receiving a cancer diagnosis in Pennsylvania, we needed to step up and make sure everyone has access to the best and most cutting-edge cancer treatments”
Rep Matt Baker, (R-Tioga/Bradford/Potter)
Author of Act 37, oral cancer treatment parity law

“Oral cancer treatment is the wave of the future,” said PBCC President Pat Halpin-Murphy. “We commend Governor Wolf for signing this law and we congratulate Rep. Baker for his commitment to the thousands of cancer patients this will impact across Pennsylvania. This will truly save lives.”

According to Rep. Baker, Pennsylvania now joins more than 40 states and Washington, D.C., in having enacted legislation to control out-of-pocket oral cancer treatment costs for patients.

3D Mammogram Coverage Information Available for PA Women

Posted By on February 15th, 2016 at 9:26 am | 0 comments.

3d-mammogram-for-PL3D mammograms are FREE for women in Pennsylvania! If you are insured under PA law or if you are covered by Medicaid in PA, 3D mammograms are available at no cost to you.

Have questions?

Click here to download our free 3D mammogram information sheet.

Click here for frequently asked questions about 3D mammograms from the PA Insurance Commission.