Home Opinion Dear Editor Companies’ Centennial plans must offer basic benefits

Companies’ Centennial plans must offer basic benefits

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I am a pulmonary, critical care and sleep medicine physician in practice in Roswell for 26 years. I have never seen a situation so bad with formulary changes in prescription plans like what is happening now. Centennial plans are the worst and affects the population that cannot pay for their medications that are not covered. Formularies are changed sometimes monthly without notification to the physician or pharmacists and no alternate comparable substitute being offered to the patient. Prior authorizations are being required for common respiratory medication for asthma and COPD. If my office was to do these preauthorizations for all these patients, I may have to hire another provider and two other support staff just for that. That is not financially possible since it is not a reimbursed service. Insurance companies know that and use this to deny needed medications to patients.

The state has to get involved in this. The state should come out with a formulary of drugs that are essential to treat common disease and require all Centennial plans to have those drugs on their formulary without requiring prior authorizations.

As of now, one insurance company has no LAMA (long acting muscarinic agent) or LABA (long acting bronchodilator agent) on the formulary. Patients with asthma and COPD are being asked to be treated with substandard regimen. This will lead to increase in exacerbations of their disease and hospitalizations. They are now trying to deny treatment to patients that have been available for 26 years.

State decides which companies are allowed to offer Centennial plans every year. They should make these companies offer basic benefits that cannot be changed for the year!

Vijay Chechani, M.D., FACP, FCCP
Roswell

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