Mass. insurers to cover in-store clinic visits

7/25/2008

BOSTON Following the approval by state health officials for limited-service medical clinics, some of the state’s largest health insurers will cover visits to the clinics to be opened in CVS and Walgreens stores later this year.

According to local news reports, Harvard Pilgrim Health Care and Tufts Health Plan have signed contracts with CVS Caremark. The retailer has stated that it plans to operate about 120 MinuteClinics across the state over the next few years. CVS is also reportedly negotiating coverage with Blue Cross and Blue Shield of Massachusetts. Together, the insurers have nearly 5 million members.

In addition, Blue Cross Blue Shield is negotiating with Take Care Health Systems, which is owned by Walgreens, according to reports. The clinic operator has stated that it plans to launch multiple clinics in the Boston-metro area through a phased approach beginning this fall. Take Care Health Systems is also talking with Tufts Health Plan to possibly extend coverage for the clinics, as well, and Fallon Community Health Plan said, according to reports, that it is negotiating to give its members coverage for clinic services.

In January, the convenient care industry celebrated a victory in Massachusetts as state health officials approved regulations allowing for limited service medical clinics, marking the end of a long review process that included two public hearings and the submission of hundreds of pages of testimony regarding the regulations.

Sparking the move to create specialized regulations: CVS’ application to open a MinuteClinic in one of its stores in Weymouth.

According to the state Public Health Council, early in the application review process it became clear that Department of Public Health regulations governing medical clinics did not address the operation of medical clinics with limited scope of services. Rather than consider applications requiring numerous waivers from full-service clinic regulations, the department decided to create a specialized set of rules.

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