Dr. Oz spotlights need for insurance coverage

Posted by on Thursday, April 28th, 2016

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CLICK HERE to watch the segment.

Nearly five years ago, 32-year-old Lindsay Rumberger was diagnosed with epithelioid hemangioendothelioma, a long name for a rare cancer that had originated in her liver and metastasized to her lungs. She underwent chemotherapy, but when a tumor close to her spine showed signs of growth, radiation was part of the recommended course. Because conventional radiation treatment threatened to cause peripheral damage to this most sensitive part of the body, her doctors recommended proton therapy instead. However, the insurance provider disagreed, calling the treatment “experimental” and refused coverage.

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Cancer is on the rise…but insurance companies refuse to pay for lifesaving treatments

Posted by on Monday, March 23rd, 2015

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More than one-and-a-half million people were diagnosed with cancer last year even as a promising number of treatments are emerging to help combat the growing epidemic, according to a new cancer report released last week by the American Society of Clinical Oncology

However, access to treatment is being hampered by barriers to insurance coverage for those procedures, and a significant number of people find their insurance does not cover promising treatments at all. Cancer treatment centers are spending an increasing amount of time fighting insurance companies to receive coverage for their patients, and preauthorization requirements have been found toincrease demands on staff time, delay or interrupt patient care, decrease patient satisfaction, and complicate medical decision making,” according to the report.

Proton therapy is a clinically-proven, FDA-approved form of cancer treatment that is not an option for many patients because most private insurers do not provide reimbursement. New methods of delivering this special form of radiation therapy mean that, for most patients, proton therapy does not cost more than traditional radiation treatment. Because of the technology’s ability to direct radiation—in the form of protons—to the exact location of the tumor, treatment can be more effective, and patients experience many fewer side effects.

A bill making its way through the Tennessee Assembly gives doctors and patients the freedom to choose the best cancer regimen, including proton therapy. Today, patients who are not covered by Medicare or are not children are typically excluded.

We’re asking Tennesseans to take action to make proton therapy available to more cancer patients. Please contact your representative or senator this week to tell them to support the Cancer Patient Choice Act. See the Tennessee Cancer Patient Coalition website.

Please urge Tennessee lawmakers to make the right choice for cancer patients. Lives are at stake.

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Tennessee & Oklahoma Fight for Proton Therapy

Posted by on Friday, March 20th, 2015

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Tennessee isn’t the only state where proton therapy advocates are busy urging legislators to require insurance companies to pay for the cancer treatment.

In Oklahoma, a similar bill has already passed the House of Representatives, unanimously, and is awaiting vote in the state Senate. Specifically, the Oklahoma legislation would prohibit insurers from requiring a higher standard of evidence for implementation of proton therapy than other cancer therapies, according to this article in The Edmond Sun.

In Tennessee, the proposed bill would provide for equal insurance coverage of proton therapy treatments as is currently available for traditional radiation. Proton therapy has been clinically proven effective in treatment of a variety of cancers including prostate, lung, liver, breast and head and neck cancers.

Although historically thought to cost more than traditional radiation therapy, newer methods allow this special form of radiation to be delivered in concentrated doses so that most patients can receive effective treatment of proton therapy for the same cost and over a shorter period of time.

Medicare covers proton therapy, but in most states private insurers do not. Tennessee and Oklahoma could break new ground by requiring insurers to allow patients and their doctors the option of choosing the best treatment for their disease.

Please visit the Tennessee Cancer Patient Coalition website. We ask that you contact your legislator and pledge support for the Cancer Patient Choice Act. Also, please join our Facebook community and share our message with your friends and family.

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