Tennessee Cancer Patients Denied Coverage for Proton Therapy by Governor’s Veto

“The Governor’s letter misrepresents the language of SB0367/HB0523, by inaccurately stating that cancer patients may be at risk for paying more for proton therapy,” states Don Denton, president of Tennessee Cancer Patient Coalition. “In actuality, there is no fiscal impact to the State or to the individual state health plan members.”

The bill, SB0367/HB0523, explicitly states, “the amount chargeable to or payable by an eligible patient for a covered course of proton therapy shall not exceed the amount that would be otherwise chargeable to or payable by the eligible patient for a course of IMRT.”

The bill would have allowed the State of Tennessee Insurance Plan to cover hypo-fractionated proton therapy for members of the state health plan diagnosed with cancer who would have otherwise been approved to receive IMRT (conventional radiation therapy) by a Board-Certified Radiation Oncologist. While both options kill the tumor, proton therapy spares damage to healthy tissue providing measurable quality of life benefits. The State of Tennessee Insurance Plan currently covers almost 300,000 people. The current State Benefit plan covers proton therapy for only 5% of cancer patients because the State relies on the recommendations of a third-party vendor hired by insurance companies who have a vested interest in limiting coverage and payments rather than providing the best possible care. The Proton Therapy Access Act would have provided state-of-the-art cancer care to hundreds of cancer patients at no additional cost to the State, the insurance companies or the patients.

“The Governor’s veto is a vote in favor of the insurance industry and against cancer patients,” says Don Denton. “By his actions the Governor has improperly adopted the insurers’ coverage positions as clinical guidelines in place of clinical decisions made by trained physicians familiar with the particular patient’s condition.”

Proton therapy spares damage to healthy tissue and nearby organs while reducing side effects, complications and recurrent cancers. By the end of 2018, there will be three operating proton therapy facilities in Tennessee. Knoxville’s Provision CARES Proton Therapy Center was the first to open in 2014, followed by St. Jude’s pediatric focused facility in 2015, and Provision CARES Proton Therapy Center Nashville, opening in 2018.

The bill was signed by both the full State Senate and House Representatives with a significant majority. The last step was to have the bill signed into law by the Governor. “Without the Governor’s signature on this bill, hundreds of cancer patients will be denied the most advanced treatment available, proton therapy,” states Denton.

History of “Proton Therapy Access Act” (source: https://legiscan.com/TN/bill/SB0367/2017)

About Tennessee Cancer Patient Coalition

The Tennessee Cancer Patient Coalition’s mission is to serve as an advocate for cancer patients and their caregivers. The Coalition believes cancer patients should have the opportunity to make informed decisions about their care and have equal access to the most advanced treatment methods available. Proton Therapy is the most advanced form of radiation treatment used to treat cancer by specifically targeting the tumor and while sparing healthy tissues. Tennessee ranks 22nd in cancer incidence rate, but 5th in cancer death rates. The Tennessee Cancer Patient Coalition was established to advocate for cancer patients and has supported legislation for equal coverage for proton therapy in Tennessee. As part of its efforts, the coalition launched a grassroots campaign to better educate legislators in hopes they make informed decisions on healthcare coverage for their constituents.

For more about the Tennessee Cancer Patient Coalition, and how you can impact future legislation see http://tncancerpatient.org or visit our Facebook page: http://www.facebook.com/tncancerpatient

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