Coalition for Wyoming Insurance Solutions

                    in Healthcare

Discretionary Clause

Medical Necessity & External Review

The Coalition for Wyoming Insurance Solutions for Health -- C-WISH -- brings together individuals and organizations looking for ways to improve access to health insurance benefits. Lead organizations are the American Cancer Society, the American Heart Association, and the League of Women Voters of Cheyenne. These organizations, along with various citizens, are participating in the search for solutions and in the presentation of the coalition's information.

 

About this website:

From time to time we will be making revisions as our work progresses. Please come back and visit us from periodically so you can stay informed of these changes. We will try to update the individual pages as events transpire that involve those subjects as well as keeping the Events and News page updated.

 

Examples of C-WISH involvement in Health Care Solutions:

 

C-WISH identified three areas that seemed to provide the most promise in resolving problems of health insurance benefits access that we felt could be addressed during the 2009 legislative session. They included:

 

· Eliminating Discretionary Clause

· Definition of Medical Necessity

· External Review Process

 

After many meetings, much deliberation, and serious discussion it was decided to present these in the form of two separate bills: the discretionary bill and the medical necessity bill which would also incorporate the external review process. We found some wonderful support from some of our legislators and a few of were interested enough to sponsor these bills. Many of our members volunteered long hours to lobbying for these bills and we successfully got these bills passed into law on March 02, 2009.

 

What's next?

 

Please see our page on Pharmacy Benefits Management. This is an issue that we are currently tackling and we welcome support! There is also a draft of the PBM Bill that is coming up and another link covers the fiscal notes on PBM.

 

We can be contacted by clicking on the “email us” link on the left hand side of the page or by sending an email to: C-Wish@c-wish.com

 

Events & News

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Text Box: Welcome to our website

Wy. Children’s

Action Alliance

Health Care

Crisis

Pharmacy Benefits Mgmt

Draft of PBM Bill

Fiscal Notes on PBM