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New MA Law mandates coverage for oral anticancer drugs

On January 3, 2013, Massachusetts Governor Deval Patrick signed into law a new bill, Chapter 403 of the Acts of 2012. This new mandate requires all health insurance plans that provide coverage for cancer chemotherapy treatment to provide coverage for prescribed, orally administered anticancer medications on a basis no less favorable than intravenously administered or injected cancer medications covered as medical benefits.

To comply with this mandate, for most plans, Blue Cross Blue Shield of Massachusetts will provide coverage for orally administered anticancer drugs without a cost share. For HSA-compliant high deductible health plans, the overall deductible will still be applicable.

For insured accounts, including Medicare supplement plans and municipal ASC accounts, this change is effective January 1,2013 upon account renewal. This change will be applied to insured grandfathered plans, and it will not impact the grandfathered status of the plan. For other renewing ASC accounts, the change will not be applied at this time unless specifically requested by the account.

We are in the process of updating our systems to reflect this change. For applicable accounts that have already renewed in 2013, once the coding change has been completed, impacted members will be reimbursed for any cost share (deductible, copayment, or co-insurance) they paid on or after their plan's renewal date.

Blue Cross Blue Shield of Massachusetts

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