Advocacy groups disagree with BlueCross BlueShield policy

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Physician and patient advocacy groups disagree with a BlueCross BlueShield of Tennessee (BCBST) policy that requires patients to utilize BCBST preferred specialty pharmacies for infusion therapies.

Previously, a provider purchased the medication and billed BCBST under a patient’s medical benefit. After the change, medications covered on the medical side of insurance to the pharmacy side. BCBST made the change to save costs.

“Today, BCBST is disrupting the current model of care and putting patients at risk,” Dr. Madeline Feldman, Coalition of State Rheumatology Organizations (CSRO) president, said. “Patients may have to delay treatments, go elsewhere (like hospitals) experiencing longer waits, and less oversight or even lose access to their treatment altogether. Forcing patients to assume these added burdens, during the COVID-19 pandemic, is shameful.”

During a pandemic is the worst time for chronically ill patients to lose access to treatments at their doctor’s offices, Feldman said. The new policy will harm public health and the economy, she said.

Advocacy groups will continue to fight for patients, Feldman said.

CSRO has alerted BCBST customers of the potential harm associated with the change and is encouraging them to share their stories. The organization also contacted BCBST and appealed to the Tennessee Chamber of Commerce.

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