Big progress continues in Vermont in ensuring insurance coverage for flat closure and revision services!
Representative Charen Fegard’s flat revision coding bill (Bill H.686) now has strong support from the state’s largest health insurer, Vermont’s BCBS. Vice President and Chief Medical Officer Dr. Josh Plavin made the following statement in support oh H.686:
“I am writing in support of the proposed Bill H.686 which requires the Department of Financial Regulation to convene a group of interested stakeholders, including representatives of health insurers, health care providers, health care facilities, and the Office of the Health Care Advocate, to develop coding and billing standards for surgical revision after chest wall reconstruction.
The expressed intention is to prevent the procedure from being denied as a cosmetic procedure. The primary concern is for those patients who have had breast cancer procedures which subsequently require surgical revisions after the initial procedure… To my knowledge we do not deny surgical revisions following chest wall reconstruction and within our policy we specifically call this specific procedure out to highlight our position.
The issue is that we are one health plan with a singular approach and our approach is not necessarily shared by other health plans that provide coverage in the state of Vermont. Therefore, in order to ensure that all Vermonters are able to receive appropriate and medically necessary care we support you in this effort.”Dr. Josh Plavin, VP & CMO BCBS-VT