Health insurance; coverage for proton therapy. (HB434)

Introduced By

Del. David Yancey (R-Newport News) with support from co-patron Del. Lee Carter (D-Manassas)

Progress

Introduced
Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law

Description

Health insurance; coverage for proton therapy. Requires any health insurer, corporation, or health maintenance organization issuing an insurance policy, subscription contract, or health care plan to provide coverage for physician-prescribed proton therapy for the treatment of breast, prostate cancer, or other indications under a hypofractionated protocol as part of a clinical trial or registry. The measure specifies the number of treatments for breast or prostate cancer under a hypofractionated proton therapy protocol. The measure specifies the amount payable for proton treatment deliveries at fixed percentages of the amount paid under CPT code 77523 as provided in the Commonwealth's Medicaid fee schedule, in order to provide that the cost of treatment under the hypofractionated proton therapy protocol does not exceed the cost of treatment for the corresponding standard intensity modulated radiation therapy (IMRT) protocol for the same indication. The measure provides that (i) if an insurer, corporation, or health maintenance organization is required to pay more for a course of hypofractionated proton therapy than their present, weighted average payment for a course of IMRT treatment, the insurer, corporation, or health maintenance organization is required to pay to the provider the amount of such average payment for the IMRT treatment and (ii) the provider is authorized to bill the patient for the difference. Read the Bill »

Outcome

Bill Has Failed

History

DateAction
01/06/2018Committee
01/06/2018Prefiled and ordered printed; offered 01/10/18 18102931D
01/06/2018Referred to Committee on Commerce and Labor
01/18/2018Assigned C & L sub: Subcommittee #2
01/19/2018Impact statement from DPB (HB434)
01/23/2018Subcommittee recommends laying on the table (7-Y 0-N)
02/13/2018Left in Commerce and Labor