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Assembly panel hears bill to boost insurance coverage of oral chemotherapy


CARSON CITY — A legislative panel heard testimony Friday for a bill that would require insurance companies that provide cancer coverage to pay a bigger share of the cost of new oral chemotherapy medications.

Sen. Mo Denis, D-Las Vegas, said Senate Bill 266 would let cancer patients seek the most effective treatment to fight the disease without having to first consider the costs of the chemo drugs.

Most health insurance policies cover traditional intravenous chemotherapy treatments as medical procedures that are fully covered once a patient’s out-of-pocket maximum has been reached. But health plans typically cover only a small percentage of ongoing prescription drug costs, requiring large out-of-pocket costs to patients.

The drugs can cost patients as much as $2,000 to $10,000 a month.

The bill attempts to create parity between the two types of treatments and would set a $100 per month co-pay maximum for the chemo drugs.

The new parity law would take effect on Jan. 1, 2014, for new and renewed insurance policies, except for policies bought from the new Silver State Health Exchange, which would take effect on Jan. 1, 2015.

Proponents of the legislation said in testimony that 23 states and the District of Columbia have approved similar legislation and not seen an increase in insurance premiums.

Supporters also said that the bill is not a mandate to cover cancer treatment, only that different types of treatments be treated equally.

Carson City resident Christy Joyce, who in 2008 was diagnosed with multiple myeloma, a cancer of the plasma cells in the bone marrow, said she is planning for the day when she will require the oral medications as part of her treatment.

Joyce said she and her husband are anticipating having to sell their home to afford the monthly costs of the medications.

Worrying about finances while trying to fight the disease is not helpful, she said.

“This oral therapy can last for years, so I’m not even sure selling our home will be enough,” Joyce said.

Sen. Joyce Woodhouse, D-Henderson, who lost her sister to brain cancer in October, said everyone should be able to use the best medical option to fight cancer and have those treatments treated equally by insurance companies.

But the bill did see some opposition.

James Jackson, representing America’s Health Insurance Plans, the trade association representing the health insurance industry, said among the association’s concerns are some groups would be exempted from the co-pay requirement, including the Medicaid program. The result would be higher premiums for those who buy insurance individually, families and small businesses, he said.

The American Cancer Society estimates that this year, nearly 13,000 Nevadans will be diagnosed with cancer, not including non-melanoma skin cancer. Of that number, about 20 percent will be diagnosed with a type of cancer in which oral anti-cancer medications are the best, and sometimes only, form of treatment.

 

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