In January, Massachusetts Governor Deval Patrick signed into law a bill that affects the member cost sharing for oral medications used to treat cancer. The new law requires insurers to cover oral chemotherapies on a basis no less favorable than coverage applied to intravenously administered or injected cancer medications.
As a result, for plans other than Best Buy HSA plans, Harvard Pilgrim will now be covering oral medications for cancer treatment obtained at a pharmacy at no charge to members. For Best Buy HSA plans, the in-network deductible that pertains to intravenously administered or injected cancer medications will also apply to oral chemotherapies.
The new mandate applies to fully-insured plans purchased or renewed on or after January 1, 2013, and Harvard Pilgrim is currently working to implement this change for fully-insured groups. Members enrolled through self-insured plans may not be subject to this mandate.