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California Minority Advocacy Groups Send Letter to Blue Shield of California Calling for an End to Discriminatory Practice that Denies Patients in Pain Access to Proper Medication
Date:11/20/2009

s coverage policy that denies California patients in pain access to critical medication. We are concerned that this practice particularly discriminates against members of California minority and low-income communities.

Blue Shield refuses to initially cover doctor-prescribed and FDA-approved treatments, instead requiring California patients in pain to try and fail on up to five medications before Blue Shield will cover the treatment initially prescribed by a doctor.

The result of this "fail first" policy is that members of minority and low-income communities are denied access to new and better medications, and that they experience prolonged pain and often deteriorating health.

When Blue Shield denies patients access to timely and effective treatment, those who need medicine for chronic pain - including Californians suffering from arthritis, multiple sclerosis, and fibromyalgia - are especially hurt. Many in the African American and Latino communities have diabetes, which includes DPN, a painful nerve condition. When Blue Shield requires those suffering from DPN to take medication that does not relieve our pain, more than our quality of life suffers.

When a mother suffering from DPN is forced to try multiple pain treatments that do not work, she often must miss work, and arrange childcare and travel, which threatens her livelihood and ability to provide for her family. It is not only unethical, but cruel, for Blue Shield to deny a patient access to a medicine the doctor knows will relieve their pain and to require the patient to go through multiple steps of taking drugs that don't work.

The U.S. Centers for Medicare and Medicaid Services (CMS) adopted a policy in March 2009 that prevents health insurers like Blue Shield from requiring patients to take more than two medications before the insurer will cover the medicine that the doctors thinks is the best treatment. In addition, the new CMS regulations pr
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SOURCE Healthy African American Families
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