Provision CARES Proton Therapy Cites Inaccuracies in Governor’s Veto Statements

May 8, 2018 |

3 min read

The bill specifically provides that proton therapy treatment must be prescribed by a Board-Certified Radiation Oncologist

KNOXVILLE, Tenn.--(BUSINESS WIRE)-- Governor Haslam’s statement regarding his veto of the Proton Therapy Access Act states that the Act “circumvents the established process for determining state employee insurance program coverage based on medical evidence and effectiveness.” According to Don Denton, President, Tennessee Cancer Patient Coalition, “State Executive Director of Benefits Administration, Laurie Lee, testified multiple times that her team lacks the resources and expertise to recommend or review coverage guidelines so they outsource those decisions to their insurance company and their insurer’s utilization manager, eviCore Healthcare Management. So, the established process the Governor refers to is simply outsourcing the decision to a third-party which has a vested interest in rationing healthcare. Relying on insurance companies to establish coverage guidelines for the latest therapies is obviously a flawed process for cancer patients given the disparity between eviCore’s proton therapy guidelines covering less than 5% of cancer incidence while Medicare covers over 70% of cancer incidence. This is clearly the case of the fox watching the hen house.”

The Governor says the State is committed to care that is “medically appropriate and fiscally responsible.” The bill specifically provides that proton therapy treatment must be prescribed by a Board-Certified Radiation Oncologist and clearly states, “the amount chargeable to or payable by an eligible patient for a covered course of hypo-fractionated proton therapy shall not exceed the amount that would otherwise be chargeable to or payable by the eligible patient for a course of IMRT” which is traditional radiation therapy. Tom Welch, President, Provision CARES Proton Therapy points out, “The bill is clearly cost neutral to the State, the cancer patient and the insurance company and places the choice of treatment in the hands of the patient and their physician. I cannot conceive of a more medically appropriate or fiscally responsible measure than that. The Governor’s veto takes away the patient’s choice and hands it to the insurance companies.”

Scott Warwick, Executive Director, National Association of Proton Therapy says, “The Governor vetoed the bill because he said, ‘it circumvents the established process.’ It is clear that the Governor is comfortable allowing eviCore, a for-profit benefit management company, to mandate treatment options to the State’s health plan Members rather than affording them a choice for better treatment. We urge the Tennessee Legislature, who overwhelmingly supported this bill, to reconvene for a special session to override the Governor’s veto in support of cancer patients across the state.”

ABOUT PROVISION CARES PROTON THERAPY

Provision CARES Proton Therapy, a non-for-profit medical provider, located in Knoxville, was the first proton therapy cancer treatment center in Tennessee, second in the southeast and 13th in the nation. Provision is the first to achieve ASTRO’s Accreditation Program for Excellence (APEx) in Knoxville and in the state of Tennessee. Provision provides a unique combination of personalized, comprehensive patient care and leading-edge technology, offering one of the most advanced cancer treatments in the world, proton therapy. An advanced form of radiation therapy that uses a single beam of high-energy protons to treat various forms of cancer, proton therapy treats tumors by directing radiation into the tumor site where doses of radiation destroy cancerous cells. Proton therapy is more precise and spares damage to healthy tissue and organs providing patients the ability to maintain a better quality of life.

For more information about proton therapy, visit www.provisionproton.com.

For more information on 2018 TN SB367/HB523 details and resources, visit www.tncancerpatient.org.