|TO:||Commercial Health Insurers, Blue Cross and Blue Shield of Massachusetts, Health Maintenance Organizations|
|FROM:||Linda Ruthardt, Commissioner of Insurance,|
Howard K. Koh, MD, MPH, Commissioner of Public Health
|DATE:||November 1, 2001|
As noted in Division of Insurance Bulletin No. 2001-04, St. 2000, c. 355 (Chapter 355) mandates coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing (HLA testing) necessary to establish bone marrow transplant donor suitability. Such coverage is required to cover the costs of testing for A, B, or DR antigens, or any combination thereof, consistent with the guidelines, criteria, and rules or regulations established by the Department of Public Health (DPH).
Pursuant to chapter 355, DPH convened an advisory group of medical experts to assist in decisions relative to the guidelines. The guidelines established by DPH in collaboration with the Division of Insurance (DOI) are attached to this bulletin.
In addition to the guidelines, carriers should note the following:
Carriers are encouraged to work with the HLA donor centers and registries in their respective service areas to facilitate the process of claims submission and reimbursement. In addition, carriers are encouraged to educate their insureds about bone marrow or stem cell transplantation and the process for HLA testing and registration.
If you have any questions about insurance coverage under chapter 355, please call the Health Unit at DOI at 617-521-7349. If you have questions about the attached guidelines, please call the Office of Patient Protection at DPH at 1-800-436-7757.