Cancer and Health Care and Insurance and WellPoint and Health Care & Life Sciences and Health Care & Insurance

WellPoint pledges two-day hospital stays after mastectomy

May 26, 2010

In its latest response to withering criticism of its breast-cancer policies, WellPoint Inc. said it will pay for breast cancer patients to stay two days in a hospital after mastectomy surgery.

The Indianapolis-based health insurer is effectively putting into practice, as of June 1, the primary provision of a bill called the Breast Cancer Patient Protection Act, which has not passed both houses of Congress.

The main sponsor of the bill, Rep. Rosa DeLauro, D-Conn., wrote on May 20 to WellPoint CEO Angela Braly asking her to commit WellPoint to the substance of the legislation.

“I hope you will join in publicly extending this very basic consumer protection—the guarantee of 48 hours in the hospital following breast cancer surgery—to the patients you insure,” DeLauro wrote.

Some states already require insurers to cover hospital stays of 48 hours if the patient and her doctor wanted that much time for recovery after mastectomy surgery. But now, WellPoint officials said, the company will make the policy standard for its customers in any state.

"Women recovering from breast cancer surgery, in consultation with their physicians, will decide whether hospitalization for 48 hours is required," Dr. Sam Nussbaum, WellPoint’s chief medical officer, said in a statement. "We are committed to making medical coverage decisions for women with breast cancer that are in accord with the latest scientific evidence and clinical research. It's important for us and our members that WellPoint continues to lead in this area.”

WellPoint has been under fire since an April Reuters article said the company uses a computer algorithm to target breast cancer patients for cancellation of their policies. WellPoint has repeatedly called the article’s claims “inaccurate and grossly misleading.”

But the article provided the basis for sharp criticism of WellPoint from President Obama, Health and Human Services Secretary Kathleen Sebelius and dozens of members of Congress. In addition, many WellPoint customers called the company concerned about their vulnerability to cancellation.

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