New Campaign Calls on Insurance Commissioners to Stop Harmful Care Delays, Inappropriate Treatment Denials
ProCure Supports New Cancer Patients’ Timely Treatment Bill of Rights
OKLAHOMA CITY (May 17, 2018) - ProCure Proton Therapy Center today announced its support for Cancer Care Denied, a newly launched advocacy campaign spearheaded by the Alliance for Proton Therapy Access, a patient advocacy organization. The grassroots effort aims to ensure all cancer patients whose doctors recommend proton therapy experience a review and appeals process that is transparent and timely, and results in fair, appropriate treatment decisions.
The Alliance for Proton Therapy Access also released a report today titled, "Cancer Care Denied: The Broken State of Patient Access to Proton Therapy", outlining the financial and emotional stress that proton therapy patients endure when insurers unfairly delay and deny treatment. This report will be used to educate Oklahomans about the challenges to accessing proton therapy and the need for a solution to make insurers accountable.
“Far too many of the patients we treat with proton therapy face some sort of delay with health insurers. Despite my detailed clinical support for why I am recommending proton therapy, insurers routinely issue immediate denials and then expose patients to an appeals process with needless delays and no credible peer evaluation,” stated Dr. Gary Larson, medical director at ProCure Proton Therapy Center. “We stand with cancer patients who are calling for a fair, timely, and transparent insurance process.”
While cancer patients and their doctors should be fighting cancer, too many patients are suffering undue health risks, anxiety, and financial hardship as they confront opaque, drawn-out insurance review and appeal processes that drastically delay or make it impossible to receive treatments their doctors prescribe.
“When I was diagnosed with Stage 3 esophageal cancer last year, my doctor told me proton therapy was my best shot to stop the cancer from spreading and save my life. I assumed my insurer would be there to pay for my treatments, but on the day I was supposed to start treatment, I found out it wouldn’t be paid for,” said Ray Houston, a former proton therapy patient. “While Medicare paid for a portion of the treatment with no delay, my private insurer wouldn’t pay their part. I appealed, but they wouldn’t budge. I ended up covering the remaining costs myself to access to best possible care my doctor recommended.”
Cancer Care Denied is calling on state insurance commissioners to adopt and enforce principles of the “Cancer Patients’ Timely Treatment Bill of Rights”. Specifically, the Alliance is advocating for the adoption of the following principles:
Fair, appropriate access to doctor-recommended treatment, with approval/denial decisions made in a transparent process, based on accurate and up-to-date clinical criteria, and appeals handled by a medically qualified expert in the type of cancer the patient is facing;
Timely access to treatment with initial approval/denial decisions made within 1 day – and appeals settled no later than 5 days – from the initial request. State insurance commissioners review final denials and hand down a decision within 15 days;
Enforcement mechanisms including: automatic approval if insurers fail to meet the 5-day expedited appeal timeline, and meaningful and substantial fines for repeated failure to provide timely, fair, appropriate approvals.
As part of this week’s campaign launch, ProCure is encouraging advocates to sign a petition to insurance commissioners and share their stories about denials or delays in care resulting from unfair insurance processes.
To learn more about the Alliance’s Cancer Care Denied campaign, visit allianceforprotontherapy.org. Follow the conversation at #CareDenied.
ProCure Proton Therapy Center in Oklahoma City is dedicated to improving the lives of patients with cancer by increasing access to proton therapy. The center opened in July 2009 as the sixth operational proton therapy center in the United States. Today, ProCure is one of approximately two dozen centers nationwide. ProCure is dedicated to excellent patient care and advancing proton therapy through innovation and improvements in technology. For more information, visit procure.com/ok.
Media Contact: Lacey Boone, Saxum
Office: (918) 956-1090 or Cell: (918) 851-2010