Blue Cross and Blue Shield of Michigan has agreed to begin covering high-dose chemotherapy and bone marrow transplants for certain cancers as part of a tentative settlement with 84 policyholders.
The settlement would bring an end to more than 10 years of litigation between Michigan's largest health insurer and cancer patients. Filed in Wayne County Circuit Court, the settlement was reached in lieu of a trial, which was scheduled to start late last month.
The Detroit-based insurer is among the last plans in the country to agree to cover the treatments, known as HDC/BMT, for early breast cancer, said William Peters, M.D., president and chief administrative officer of Detroit Medical Center's Barbara Ann Karmanos Cancer Institute, where many of the plaintiffs in the class-action lawsuit are patients.
The cancer institute was not a party to the lawsuit.
For years the Michigan Blues denied coverage on the basis that the treatment was experimental, despite widespread acceptance in the medical community.
In the settlement, the Blues agreed to submit a rider to the Michigan Insurance Bureau to expand its coverage of the treatment for stages II and III breast cancer, all ovarian cancers and multiple myloma.
The Blues also agreed to reimburse subscribers who had to pay for their treatment, and pay $600,000 to fund cancer research at the University of Michigan Medical Center in Ann Arbor and the Karmanos cancer institute.
Blues spokeswoman Helen Stojic said the plan couldn't estimate the total settlement cost because it doesn't know how many patients will undergo the procedure.
Terms of the settlement must be approved by the court, and the rider must be approved by the state insurance bureau. Class-action members also must be given an opportunity to object.