The Tennessee Cancer Patient Coalition is gearing up and needs your support. Led by prostate cancer survivor Don Denton, the Coalition aims to pass legislation that ensures Tennesseans have the right to choose the best treatment options and that insurance companies cover the treatment.
Tennessee ranks 22nd in cancer incidence rate but 5th in cancer death rates. The most advanced radiation treatment in the world, proton therapy, is available in Tennessee, but because private insurers refuse to provide meaningful coverage, most Tennesseans do NOT have access to it.
Proton therapy should be covered for all commercially insured patients and Tenncare patients just as Medicare patients are covered.
However, since commercial insurers have, in general, refused to cover proton therapy, Senator Overbey and Representative Haynes have filed the “Cancer Patient Choice Act” in the Tennessee legislature which states: “To afford eligible patients the right to choose the form of radiation therapy that their physician determines will result in the best clinical outcome and to further research and facilitate the accumulation of proton treatment data without increasing costs above current IMRT costs, all physician-prescribed proton therapy for the treatment of breast or prostate cancer under a hypo-fractionated protocol as part of a clinical trial or registry must be covered by both the patient’s commercial insurance as an in-network service and by TennCare.”
To read the entire bill, click here.
Proton therapy is neither an investigational nor experimental treatment. Proton therapy was cleared by the FDA in 1988 and Medicare provides broad coverage for most common cancer indications. Most patients between the ages of 19 to 64 are denied proton therapy insurer reimbursement.
As far as we can determine, proton therapy is the only cancer treatment covered broadly by Medicare and not covered by commercial insurance for the same indications. This may be the result of Obamacare, since Obamacare passed on the responsibility of determining what is covered in the Obamacare Exchange Plans to the insurers who provide those plans.
Proton therapy precisely delivers a curative dose of radiation to the tumor, and improves the cancer patient survival rate, spares the surrounding healthy tissue, reduces side effects and secondary malignancies and increases the patient’s quality of life.
The top 10 cancer centers in the United States, including MD Anderson, Mayo Clinic, and Memorial-Sloan Kettering, either have or are developing proton therapy centers. There are 14 operational proton centers in the US, 14 under construction, and 15 under development. Tennessee has one proton center operational (Provision Center for Proton Therapy in East Tennessee), one under construction (St. Jude in Memphis), and one under development (Scott Hamilton Proton Center in Middle Tennessee).
The cost of proton therapy continues to decrease as clinicians realize its unique potential for treating the cancer with far fewer treatments of higher doses; and in many cases today, the cost for proton therapy is less than the cost of other forms of treatment.
Insurance companies are making record profits as they refuse to pay for doctor-prescribed treatments. Since Obamacare became law, the big for-profit insurers are making record profits. Their stock price has more than doubled and in many cases more than tripled. At the same time, there is evidence that, to enhance the bottom line, they have been dumping unprofitable individually insured customers and small-business customers and refusing to pay for physician-prescribed care, including proton therapy.
Please visit the Tennessee Cancer Patient Coalition web site. We ask that you contact your legislator and pledge support for the Cancer Patient Choice Act (SB-0902 & HB-1006). Also, please join our Facebook community and share our message with your friends and family.