Legislative Update: November 22nd
The past week has been one of grave concern. The Mandated Health Benefits Commission met on Monday, November 20th, to vote on whether or not to make it mandatory for insurance companies to cover Intensity Modulated Radiation Therapy, as given by the Mid Rivers Cancer Center in Montross. In a 9-3 vote they decided to pass a recommendation along to the House Commerce and Labor Committee that insurance reimbursement for this cancer treatment not be made mandatory.
The reasoning behind the decision of the Mandated Health Benefits Commission was flawed in a number of ways. Their main reasoning for not making a recommendation to require insurance payment for this treatment was that they should not mandate new types of treatment and if this is a good treatment insurance companies will eventually provide coverage. This reasoning is flawed in two major areas.
The first major flaw is that when an insurance company arbitrarily denies coverage of a medical treatment that has been documented in peer reviewed journals as being less toxic and therefore a safer treatment for the patient it is the job of the state to hold that company accountable and mandate that the treatment be covered.
The second major flaw in this argument is that if a cancer treatment is not covered by insurance companies it will not be administered to enough patients to provide the level of proof these companies say they need to approve payment.
The insurance companies have been presented with studies and documents that show this radiation treatment to be safer than other types. These studies irrefutably demonstrate that this treatment reduces radiation to non-cancerous cells. It is also documented that shielding these cells is the only way to reduce the toxicity of radiation. Solid Compensator Intensity Modulated Radiation Therapy is the best treatment available to shield non cancerous cells. For the insurance companies not to cover this and the Mandated Health Benefits Commission make to recommend against requiring them to pay for this treatment is disturbing.
Their decision is especially concerning when considering the testimony that was provided regarding this treatment. The proponents of the bill were numerous highly credible doctors in the field of radiation oncology. Speaking in opposition to this bill were Anthem Blue Cross Blue Shield and the Virginia Association of Health Plans. The only argument that they presented was that there should not be mandates for this radiation treatment.
I believe that we should not have to have mandates, but realistically they are necessary in certain situations such as this one. This legislation will go before the House Commerce and Labor Committee during the 2007 session. I urge all of you who are interested in seeing this legislation pass to contact the members of the committee and let them know why they should vote in favor of mandating that insurance companies cover Solid Compensator Intensity Modulated Radiation Therapy.
The members of this committee are Delegates Harvey Morgan (Chairman), Vincent Callahan, Frank Hargrove, Robert Tata, Harry Purkey, Terry Kilgore, Kathy Byron, Lee Ware, Allen Dudley, Morgan Griffith, Sam Nixon, Terrie Suit, Timothy Hugo, Watkins Abbitt, Kenneth Plum, Joseph Johnson, Dwight Clinton Jones, Johnny Joannou, Kenneth Melvin, Kenneth Alexander, Mark Sickles, and Jennifer McClellan. They can receive mail at the following address: General Assembly Building, P.O. Box 406, Richmond, Virginia 23218.
Additional information on this legislation is available on my website, www.delegatewittman.com. If I can be of assistance please do not hesitate to contact me by phone, 804-493-0508, or email, robwittman@verizon.net.
The reasoning behind the decision of the Mandated Health Benefits Commission was flawed in a number of ways. Their main reasoning for not making a recommendation to require insurance payment for this treatment was that they should not mandate new types of treatment and if this is a good treatment insurance companies will eventually provide coverage. This reasoning is flawed in two major areas.
The first major flaw is that when an insurance company arbitrarily denies coverage of a medical treatment that has been documented in peer reviewed journals as being less toxic and therefore a safer treatment for the patient it is the job of the state to hold that company accountable and mandate that the treatment be covered.
The second major flaw in this argument is that if a cancer treatment is not covered by insurance companies it will not be administered to enough patients to provide the level of proof these companies say they need to approve payment.
The insurance companies have been presented with studies and documents that show this radiation treatment to be safer than other types. These studies irrefutably demonstrate that this treatment reduces radiation to non-cancerous cells. It is also documented that shielding these cells is the only way to reduce the toxicity of radiation. Solid Compensator Intensity Modulated Radiation Therapy is the best treatment available to shield non cancerous cells. For the insurance companies not to cover this and the Mandated Health Benefits Commission make to recommend against requiring them to pay for this treatment is disturbing.
Their decision is especially concerning when considering the testimony that was provided regarding this treatment. The proponents of the bill were numerous highly credible doctors in the field of radiation oncology. Speaking in opposition to this bill were Anthem Blue Cross Blue Shield and the Virginia Association of Health Plans. The only argument that they presented was that there should not be mandates for this radiation treatment.
I believe that we should not have to have mandates, but realistically they are necessary in certain situations such as this one. This legislation will go before the House Commerce and Labor Committee during the 2007 session. I urge all of you who are interested in seeing this legislation pass to contact the members of the committee and let them know why they should vote in favor of mandating that insurance companies cover Solid Compensator Intensity Modulated Radiation Therapy.
The members of this committee are Delegates Harvey Morgan (Chairman), Vincent Callahan, Frank Hargrove, Robert Tata, Harry Purkey, Terry Kilgore, Kathy Byron, Lee Ware, Allen Dudley, Morgan Griffith, Sam Nixon, Terrie Suit, Timothy Hugo, Watkins Abbitt, Kenneth Plum, Joseph Johnson, Dwight Clinton Jones, Johnny Joannou, Kenneth Melvin, Kenneth Alexander, Mark Sickles, and Jennifer McClellan. They can receive mail at the following address: General Assembly Building, P.O. Box 406, Richmond, Virginia 23218.
Additional information on this legislation is available on my website, www.delegatewittman.com. If I can be of assistance please do not hesitate to contact me by phone, 804-493-0508, or email, robwittman@verizon.net.
posted by Blake Hite at 8:20 AM
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