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Tennessee governor vetoes state employee proton therapy coverage

by John R. Fischer, Senior Reporter | May 09, 2018
Rad Oncology Proton Therapy
Governor Bill Haslam has vetoed a
bill that would require state employee
insurance to cover proton therapy
Tennessee Governor Bill Haslam (R.) has vetoed a bill that would make coverage for proton therapy mandatory under state employee insurance plans.

Haslam asserted that the bill, passed by both the Tennessee House and Senate, would burden patients with excessive charges from out-of-network providers and put them at risk. The bill was sponsored by physician and senator Mark Green (R.) and representative Bob Ramsey (R.).

“The provider advocating this bill rejected a medically appropriate plan for expanded coverage to instead pursue a political mandate,” Haslam said in a statement. “The state is committed to high-quality care that is medically appropriate and fiscally responsible for patients and taxpayers, but this mandate could put patients at risk and expose them to excessive charges from out-of-network providers.”

If passed, the bill would require the state group insurance program to cover physician prescribed hypofractionated proton therapy under the same aggregate amount as intensity-modulated radiation therapy.

Coverage would extend to patients in a clinical trial or registry and prescribed by a board certified radiation oncologist. Aggregate cost would be required to equal the average cost paid by the state for an entire course of IMRT treatment for the delivery of the same biologically effective dose.

Prior to the veto, the bill cleared way to become law in both the Tennessee Senate and House in votes of 29-1 and 82-13, respectively.

Green and Ramsey have called for a special meeting to consider overriding the veto, a move supported by executive director Scott Warwick of The National Association for Proton Therapy.

“His statement that the bill could 'put patients at risk and expose them to excessive charges from out-of-network providers' is incorrect and misguided,” Warwick told HCB News. “The bill's language, which improves access for cancer patients on the state health plan who would benefit from hypofractionated proton therapy, explicitly states that there will be no additional cost over standard IMRT to the patient, the state, or its insurers. We hope that the Tennessee legislature, who in an overwhelming majority voted in favor of this bill, will reconvene for a special session to override the veto in support of cancer patients across the state.”

Dr. Green, a survivor of colon cancer who did not have the option of proton therapy, says the bill would ensure that others have access to another, and in many cases, more effective alternative to conventional radiation that was not available to him.

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