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OKLAHOMA CITY (AP) — Legislation that prohibits health insurers from holding proton radiation cancer therapy to a higher standard of clinical effectiveness than other radiation treatments received final approval in the Oklahoma Senate on Monday.
The Senate voted 36-9 for the House-passed measure following assurances from the bill's author that the measure is not an insurance mandate, sending it to Gov. Mary Fallin for her signature. Fallin spokesman Alex Weintz said the governor will review the bill before deciding whether to sign it into law.
Proton therapy is a medical procedure that uses a beam of protons to irradiate diseased tissue. It was approved for cancer treatment by the Food and Drug Administration in 1988.
Its chief advantage over other radiation therapy treatments is it can more precisely localize the radiation dose, reducing side effects to surrounding tissue, the measure's author, Sen. Ron Sharp, R-Shawnee, said.
"You do not have to worry about the surrounding organs," Sharp said. "It's the secondary problems we have to look at here. The cure might be killing the patient," he said of other radiation treatments.
But some health insurers regard the therapy as experimental, and its cost had prompted some insurers to require it meet an even higher level of clinical evidence than other forms of radiation therapy.
Sen. Brian Crain, R-Tulsa, said lawmakers have been reluctant in the past to tell insurers what they can and cannot insure. But Sharp said the measure does not require insurers to cover proton therapy costs but provides guidelines for insurers to use when deciding whether to cover the therapy, including recommendations by the patient's physician.
"There is absolutely no mandate in this legislation," Crain said.
Passage of the bill was welcomed by Marie Enderton, 56, of Blanchard, a cancer survivor who was present at the Capitol for final passage of the bill and credits proton therapy with saving her life.
Enderton underwent proton therapy treatment for lung cancer last summer. She said she personally paid about $5,000 for the treatment after her health insurer refused to pay for it.
"I was unable to get approval from my insurance company," Enderton said. "They said it was experimental. They just don't cover proton radiation. They would cover surgery, which I was not a candidate for."
Since completing the therapy, Enderton said scans indicate she is cancer free.
"This did not kill me, it actually cured me," Enderton said. "I believe it saved my life."
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Online:
House Bill 1515: http://bit.ly/1Ea8MQC
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