Variation in medicaid coverage for hematopoietic cell transplantation.
OBJECTIVE
Variation in Medicaid policies among states may lead to differences in coverage for complex treatments. This article uses hematopoietic cell transplantation (HCT), an established treatment for patients with hematologic cancers, as a case study to highlight state variation in Medicaid coverage of complex oncology treatments.


METHODS
Information on HCT coverage benefits for 2012 was collected from state Medicaid Web sites and was compared with recommended HCT benefits developed by multiple stakeholders. Coverage was reviewed for five categories: one, transplantation procedure; two, donor search; three, prescriptions; four, clinical trials; and five, patient food, lodging, and transportation. Coverage was coded on a three-point scale for each category for each state. States were ranked by the number of variables for which they met recommended benefits criteria (maximum rank score, 5).


RESULTS
Detailed information on Medicaid coverage was available for 47 states. No state provided the recommended coverage benefits in all five categories. Prescription coverage most often met the recommended criteria, whereas only a small number of states provided clinical trial coverage for HCT. There was substantial variation in Medicaid coverage for HCT by state.


CONCLUSIONS
Findings highlight substantial variation in Medicaid coverage for HCT by state, which may increase disparities in access for already medically underserved populations.
National Marrow Donor Program; and Center for International Blood and Marrow Transplant Research, Minneapolis, MN.
Jaime M
JM
Preussler
National Marrow Donor Program; and Center for International Blood and Marrow Transplant Research, Minneapolis, MN.
Stephanie H
SH
Farnia
National Marrow Donor Program; and Center for International Blood and Marrow Transplant Research, Minneapolis, MN.
Ellen M
EM
Denzen
National Marrow Donor Program; and Center for International Blood and Marrow Transplant Research, Minneapolis, MN nmajhail@nmdp.org.
Navneet S
NS
Majhail
D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D014481:United States