Joy Griffith couldn't be happier. The 36-year-old mother of two, who's in a high risk category for getting breast cancer, will have her mammogram covered after months of denials by the state employee's health care plan.
The change comes after the plan's Chief Medical Officer, Dr. Daniel Lesser, heard Joy's story and decided to overturn the denial.
It doesn't stop there. He's called for a full review of the plan's mammogram policy.
“I think what we've realized is that the policy as written doesn't address women who are at high risk of breast cancer,” he said.
Currently the plan only covers mammograms for women over 40, but Joy's high risk because she's under 40 and because her mother had pre-menopausal breast cancer.
State law says the mammograms should be covered if your doctor recommends it, but since the state plan is self insured, it doesn't have to follow the law.
But Dr. Lessler says that may change
“My concern and I think the concern of everyone at the United Medical Plan is that we are doing all we can to assure that the people we insure are getting the best, most evidence-based care and that's the right thing to be doing,” said Dr. Lessler.