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DECEMBER, 2007 GLHF ADVOCACY COMMITTEE MEETING MINUTES
Conference Call
Members in Attendance: Stacy Brault, Fred Tamms, Steve McMurtry
Members Absent: Darcy Zwier, Barb Ditrich, Michelle Cecil, Shelly
Mattson Celine Caithamer
Staff in Attendance: Kathleen Roach, David Linney
The meeting was called to order at 5:35 p.m.
Legislative Day at the Capitol
The committee agreed that the day was a great success. Ideas for a future
legislative day include: 1. Having envelopes the day of the event to hand out to
participants to send thank you letters after meeting with their respective
legislators, 2. Having people bring visual aides such as a poker chip to show
the size of a bruise or a vile to show how much a vile of factor product costs,
3. Proving participants with a list of legislators who everyone is meeting with
so if they want to go to other appointments, they know who the legislator is and
what time the appointments were scheduled and 4. Encourage others to attend.
Anthem/Blue Cross
Kathleen and David Linney met on 11/29/07 with Anthem and Precision RX
representatives:
- Michael Jaeger, M.D., Medical Director, Anthem Blue
Cross and Blue Shield of Wisconsin
- Debbie Riepl, Senior Network Development Analyst,
Anthem Blue Cross and Blue Shield
- Rita Grafchik, Director of Clinical Programs and
Nursing Services for Precison RX Specialty Solutions
Precision Rx is a subsidiary of Wellpoint, a for profit corporation. Anthem,
which is also a subsidiary of Wellpoint, includes franchised Blue Cross & Blue
Shield plans in 14 states including Wisconsin. Wellpoint covers 35 million
lives.
Precision Rx, a specialty pharmacy, operates out of Indianapolis. Anthem
usually requires the use of Precision Rx or a 340B pharmacy, but contracting is
determined by the individual BC/BS state plans. Patients also have the option
of using an out-of-network provider, but would be subject to paying
out-of-network/out-of-pocket costs. Precision Rx charges no administrative
fees.
Patient coverage of factor products is covered as a benefit that is subject to
the lifetime limit of the patient’s policy.
Precision Rx promotes the use of HTCs. It includes a specialty team devoted to
hemophilia service. It is open 9:00 am to 9:00 pm EST. There is an on-call
service 24 hours a day 7 days a week. Nursing assessment, monitoring and
counseling services are provided. Home nursing services are coordinated if
needed for home infusion. All factor products are provided. There is an open
formulary and no “Step Therapy” requirements.
Precision Rx will work with patients and prescribing physicians to maintain a
number of “on-hand doses” so that the patient will maintain extra factor product
for an emergency.
Precision Rx will also provide emergency factor supply, even using as outside
provider if necessary.
Precision Rx has thus far only identified 3 Wisconsin hemophilia patients. It
plans to notify policyholders and providers by letter about the Precision Rx
program and to call the 3 patients. It will also include an article in their
next newsletter.
Standard of Service Update
MASAC will review the standard of service document at their March/April meeting
and make a decision at that point on how to implement the document.
Green Bay Advocacy Core Team (ACT) Report
Ms. Brault reported that the ACT committee has been quiet this past month due to
the Green Bay HTC moving into a new facility. They are hoping Senator Dave
Hansen attends the grand opening of the building.
Mission Moment
Kathleen shared the Board of Directors mission moment on December 6 will be the
results of the Legislative Day. She will share pictures, the proclamation
signed by Governor Doyle, pass out poker chips and show a few newspaper
articles.
Strategic Planning
Kathleen requested that all advocacy committee members participate in the
strategic planning process on Thursday, January 10 from 6:00-9:00 p.m. Thos who
cannot make it to Milwaukee in person can participate by conference call. It is
important to GLHF to get input from the bleeding disorder community to gather
ideas on future programs and services.
Washington Days
This event will take place March 5-7, 2008 in Washington DC. Kathleen explained
that this year there is limited funds and GLHF will only send two or three
families. Those who attended the Madison Legislative Day and those who have not
attended Washington Days in the past three years are eligible to apply.
Next Meeting The next meeting will be set for February. Possible dates
will be sent out to committee members.
The meeting was adjourned at 6:40 p.m.
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