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.