Anthem Blue Cross and Blue Shield medical insurance companies, 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 Anthem’s existing leadership in breast cancer treatment. While variability exists within clinical guidelines and state regulations, the vast majority of Anthem’s members already receive the standard of care indicated in the legislation. However, Anthem 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, Anthem 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 Eina G. Fishman, MD, MS, CPE, Anthem Blue Cross and Blue Shield Medical Director. “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 we continue to lead in this area,” she 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 Fishman. “Our goal is to ensure that our members receive optimal care.”

Anthem also champions effective member communication and transparency regarding breast cancer diagnosis and treatment options. More than 3,000 nurses and clinical associates nationwide 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, Anthem is taking steps to provide comprehensible, straight-forward explanations of benefits so that members more clearly understand their treatment options.

“I am proud of Anthem’s record in improving care for women with breast cancer in this state. Connecticut was a leader by being one of the first states to enact legislation in 1997 providing this benefit for women with breast cancer,” said David R. Fusco, president, Anthem Blue Cross and Blue Shield. “We commend Representative DeLauro and her fight to take the protection afforded to Connecticut residences to the rest of the nation.”

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