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STATE RIGHT ON CO-PAY FOR SELF-INJECTABLE DRUGS

Bravo, Gov. Pataki and Insurance Superintendent Neil D. Levin! They did the right thing when they decided to correct a long-standing discrepancy in health-insurance practices.

For years health plans have been allowed to charge a different co-payment for self-injectable drugs than for other drugs.

This fact came to the forefront a few months ago when, after years of having a low co-payment and enrolling a disproportionate share of special-needs patients, Independent Health was forced to propose an adjustment to our co-payment for self-injectable drugs so that it would match that of our largest competitor, Community Blue.

We simply wanted to be able to provide this benefit for our members in an environment where other local health plans are demonstrating their willingness to care for those most in need. So, with the help of the Western New York delegation of the state Legislature, the Erie County Legislature and our members, we worked with the insurance department to enforce regulations that would ensure that all New York health plans have a level benefit for these drugs.

We are disappointed that this issue had to be pushed to the regulatory level because one local health plan refused to make this change voluntarily. However, we are delighted with the final outcome.

Because so many parties worked cooperatively on this issue, hundreds of patients with special needs will be charged an affordable co-payment -- assuring them access to needed medications -- no matter which health plan they choose.

Michael W. Cropp, M.D.
Medical Director
Independent Health
Buffalo