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Here's news and info about three primary blood cancers, Lymphoma, Myeloma and Leukemia with a decided patient's perspective.  I hope this helps whether you're newly diagnosed or veteran survivor.  

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Oral Chemotherapy Parity Bill

We are so close.   The Commonwealth of Massachusetts could be the 20th state to adopt legislation the corrects a serious inequity and discriminatory practice in cancer care.  Currenty when a subscriber to a healthcare insurance provider requires chemotherapy and that chemo is given by way of a traditional intravenous (IV) infusion, he or she will normally receive 100% reimbursement or direct paid coverage.  If patient receives one of the emerging 'targeted therapies' in a pill form, the insurance company can determine that is pharmacy coverage for which a co-pay of up to 30% or more is required.  This means patients who must take pill form for some of the incurable blood cancers such as mine, will incur substantial pharmacy costs while the costs to the healthcare insurance provider, the healthcare provider and in some cases the state or federal healthcare service sees dramatic savings realized from the much lower cost pill form chemo.

For the past month, I've been working crazy hours and effort in conjunction with the Leukemia & Lymphoma Society and one of their third party professional services firms that guides them through the state and federal legislative process.  I have walked the hallways and lobbys (yikes, does that make me an unofficial lobbyist) and offices of legislators from the Massachusetts Senate and House of Representatives meeting with lawmakers and their staffs.  In addition, my outgoing email is running at an all-time high while my outgoing phone calls are non-stop.  Ok, this is personal.  I can swing the costs but there are many that may have to choose whether to take pill form or eat or pay the rent.  Also, important, getting the insurance companies to pay for the services for which their subscribers pay, is fiscally responsible for all.

Off the record, insurance providera are not against this legislation, they just don't want to engage the Senate and House because they feel the government shouldn't be making mandates telling them how to run their business.  Even if it means siginificant savings for them, insurance companies won't speak up and support this bill.  I'm not aware of any vocal opposition.  My concern is the bill could fail because of misinformation, lack of information or we simply run out of time, scenarios all too familiar to many cancer patients. 

I've written  letters to many of the leading print and on-line publications in Massachusetts explaining what's important about this bill.  Most of the press picked up the story.   As of last Friday, it looked like it could sail through the House of Representatives, but late in  the day someone attached an amendment which has wording that would neutralize this bill, make it ineffective, because it gives insurance companies 'the out' they need to decline full coverage for oral chemotherapy.  This is a classic example of eleventh hour positioning, something that could derail this most important piece of legislation. 

If all goes as we hope, we could get approval as early as tomorrow as both sides of the aisle are supporting this.

 

 

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