Friday letters: Insurance companies tying doctors’ hands

August 16, 2013 

— In my 28 years of medical practice as a board-certified plastic surgeon, I too often witnessed insurance companies making decisions about patient care and coverage seemingly without concern for what was in the best interest of my patients.

Now, as a patient myself, this issue has become personal.

I am on my fourth drug to treat my rheumatoid arthritis, and this medication, called Cimzia, has been by far the most successful. But it is given by injection, so I must go to the office of my physician to receive it.

Due to the crippling effects of my arthritis, I am simply not able to give myself the injection — and neither are thousands of other RA patients whose illness has destroyed their dexterity. Yet that is exactly what some Medicare carriers are now requiring us to do.

By placing Cimzia on the self-administered drug exclusion list, they may force Medicare patients to discontinue its use, thereby terminating any therapeutic benefit that has been achieved or is in progress. Terminating coverage will penalize all Medicare patients who are dependent on physician-administered Cimzia and will eliminate a therapeutic option for other patients who become incapable of self-administration.

Medical decisions should be made by doctors, not insurance companies. I urge Columbia-based Medicare contractor Palmetto GBA and other insurance companies to rethink and reverse these cruel and unreasonable policies.

Dr. Robert Leonard


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