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Cancer treatment coverage in new health plans complicated by narrow network

Though local cancer doctors are part of the Anthem Blue Cross Blue Shield narrow network plan being sold on the Affordable Care Act marketplace, local patients probably can’t receive treatment there.

Medical oncology at Concord Hospital is provided by New Hampshire Oncology and Hematology, an independent practice with offices in Laconia, Hooksett and Londonderry. The practice and all employed physicians are part of the network.

But radiation, lab tests and scans for patients receiving treatment at Concord Hospital would be done by Concord Hospital staff, who are not part of the network. The treatment and tests would not be covered by the plan.

The other New Hampshire Oncology and Hematology sites are part of the network, said Dr. Peter Crow, a physician partner at the practice.

“Technically, we are part of the network, but in simpler terms, in the way the community views the (Payson Center for Cancer Care), someone on that plan couldn’t get treatment there,” Crow said.

More than 21,500 New Hampshire residents had signed up for a plan on the marketplace by the beginning of this month, according to the Kaiser Family Foundation.

The Associated Press surveyed some of the nation’s best cancer hospitals and found that many are off-limits to patients on the new marketplace plans that were created as part of the federal Affordable Care Act.

Anthem is the only company selling plans on New Hampshire’s marketplace this year. It has created a network for that plan that excludes 10 of the state’s 26 hospitals, including Concord Hospital.

Dartmouth-Hitchcock Medical Center and its physicians, including the Norris Cotton Cancer Center, is on the network.

The AP survey found examples in all corners of the country. Seattle Cancer Care Alliance is covered by only three out of eight insurers in Washington’s insurance exchange. MD Anderson Cancer Center in Texas told the AP it’s on fewer than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two others.

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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