Kaiser's Bid for $500 Cap on Drug Coverage Rejected
October 11, 2002
The California Department of Managed Health Care has rejected a request from Kaiser Permanente, the state's largest HMO, to set limits as low as $500 on coverage for prescription drugs in some insurance policies. CDMHC Director Daniel Zingale said his agency is conscious of the growing cost of prescription drugs but that cost-cutting efforts must be designed so they do not endanger people. "A person with HIV faces drug bills of $15,000 per year to stay alive," Zingale wrote Wednesday in a letter to Kaiser Chair and CEO George Halvorson. "No one with heart disease, cancer, diabetes or HIV should be denied lifesaving drugs." Kaiser spokesperson Matthew Schiffgens said the HMO had withdrawn its request the day before Zingale rejected it, but he maintained the insurer views drug caps as reasonable, given current medical economics. The caps would have applied to some members of Kaiser's individual and small-group policies. State law allows the sale of individual policies with no drug benefit; however, once a plan includes any prescription coverage, certain minimum standards apply, such as mandatory coverage of diabetes drugs, contraceptives and pain management medication.Adapted from:
Los Angeles Times
10.11.02; Charles Ornstein
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.