Down but not out—fight for proton therapy continues

Posted by on Thursday, April 14th, 2016

blog-ft-image-insurance-hurdles

It was a promising year for legislation that would nudge insurance companies toward coverage of proton therapy for cancer patients.

However, after two bills promoting commercial payment for proton therapy were tabled in Tennessee House of Representatives committees, it’s the third year such bills have met with the same result. In both cases the House committees failed to take up a vote on the measures, leaving them to essentially die on the vine—at least for this legislative year.

While the measures didn’t pass, there were some positives takeaways. The bills were proposed by legislators themselves and had grassroots support. This showed that local awareness of proton therapy is growing and that our legislators are increasingly viewing it as an important cancer treatment option.

We encourage patients and their families to connect with their legislators, whatever the state, to promote the importance of proton therapy and encourage insurance coverage. A bill promoting the use of proton therapy passed in the Oklahoma state legislature last year and this year a proton therapy measure was proposed in Virginia, in addition to the two in Tennessee.

But legislation is not the only tactic for combatting the problem of insurance coverage.

Provision will work to increase public awareness of insurance companies’ failure to widely cover proton therapy for cancer patients—resulting in some patients seeking alternative treatments with undesirable side effects or scrambling to pay the costs out of their own pockets, according to Scott Warwick, vice president of program development and strategic initiatives for Provision Center for Proton Therapy

“We believe when the public realizes that insurance companies are preventing patients from getting the medical care they need, they will help put direct pressure on insurance companies to pay for proton therapy,” he says.

Another strategy is for companies that are self-insured is to request providers add proton therapy coverage to their policies. Provision, for example, covers its own employees for proton therapy through Cigna. Seventy percent of people covered for health care under commercial insurance are included in these company-funded plans, affording the opportunity for proton therapy to be included in the policy at little extra cost.

At the same time, he says, Provision will continue, as it has for the past several years, to dialogue with insurance companies in an effort to “come to agreement on reasonable coverage terms for proton therapy.”

Thanks to all the patients who contacted our legislators this year to urge passage of the bills. With a consolidated effort by continued patient support your voice will be heard. Please voice your opinion to legislators and your insurance companies in support of proton therapy, a life-changing cancer treatment.

Posted by on Thursday, April 14th, 2016