Emails Reveal Strategy To Pass Proton Therapy Bill
News Channel 5
A controversial bill requiring insurance companies to cover a specific type of cancer treatment moved forward Wednesday in the Tennessee legislature.
The bill would require some private insurance companies to cover proton therapy treatments for most types of cancer. It passed without objection in the House Insurance and Banking Subcommittee.
NewsChannel 5 Investigates raised questions last week about who stands to benefit from the bill.
In January, Dr. Terry Douglass, who is a longtime friend of Tennessee Gov. Bill Haslam, opened the $115 million Provision Center for Proton Therapy Center in Knoxville.
While the facility was under construction, the Wall Street Journaland other media reported that major insurance companies across the country were reducing or discontinuing coverage for proton therapy — which is more expensive than traditional cancer treatments.
Dr. Douglass and the Provision Center for Proton Therapy Center have now hired seven lobbyists to push the insurance mandate through the legislature.
Douglass asked lawmakers require coverage for the treatments during a hearing before the House Insurance and Banking Subcommittee two weeks ago.
“Our center is not financially viable if half our patients cannot be paid for through private care reimbursement,” Douglass said.
Opponents of the bill, like James Scothorn, who is CEO of Tennessee Urology Associates and a competitor, are concerned by what he called attempts to quietly push the bill through the legislature.
In fact, e-mails obtained by NewsChannel 5 Investigates raise questions about how transparent supporters wanted to be.
Notes from a phone call, involving one of the seven lobbyists hired by the Provision Center for Proton Therapy, discussed how other legislative battles “may allow us to come in somewhat under the radar.”
The bill seemed to catch state officials off guard. House Bill 264 was originally introduced as a dental bill, but it was rewritten two weeks ago to require coverage for proton therapy.
“We too just got the bill this morning,” said Tony Greer with Tennessee Department of Commerce and Insurance in front of the House subcommittee two weeks ago. “We didn’t see it yesterday. We are still in the middle of analyzing it right now.”
Scothorn said he was also caught off guard. “It seemed a little bit unfair because nobody heard about it until last week, and then we’re already behind the eight ball in being able to fight what’s going on.”
Proton therapy beams protons at cancer tumors which, advocates claim, reduces side effects.
But critics say, in most cases, it’s no better than traditional radiation, and costs a lot more.
While Medicare covers the treatment, private insurance companies have refused to cover it for many cancers.
Terry Douglass has a significant amount of money invested in the $115 million facility.
Just last year, the center pushed a bill that would put the University of Tennessee on the hook for $98 million if the project failed.
The bill died after lawmakers worried about the risk to taxpayers.
Bill Hansen, VP of strategic development for the Provision Center for Proton Therapy, said in a statement that the purpose of the bill was so the center could secure long-term, low-cost bond financing. He said, “In return UT was to receive 20% ownership in the proton center.”
Other e-mails obtained by NewsChannel 5 Investigates reveal Douglass questioned the need to even involve the legislature.
He asked in a document sent to the sponsors of the bill last month if the governor could issue an executive order requiring insurance companies to cover proton therapy.
He also asked if the governor could include coverage in his budget bill.
Douglass also questioned whether the governor could require coverage of proton therapy for state employees or people on TennCare — both groups are exempt from the current bill.
But supporters of the mandate insisted that this is not just about money.
“It is a jobs bill and an economic development bill, but more importantly a health care bill,” said Sen. Doug Overbey, who is a sponsor.
The Maryville Republican told lawmakers earlier this week that the for-profit arm of the Proton Therapy Center, called ProNova, plans to sell proton therapy equipment. He said it could lead to thousands of jobs.
But only if the center can support itself.
Last week, Haslam called the bill an insurance mandate and said he does not support insurance mandates.
In an e-mailed statement Bill Hansen with the Provision Center Proton Therapy clarified what the center means when it says it is “not financially viable” unless private insurance companies are forced to cover proton therapy:
“The center’s continued operation is not at risk. Financial viability in this context refers to the long-term sustainable, independent operation of the center without further outside support or contributions, which, in turn, would establish the center as a prime candidate for research grants and technology initiatives that would serve to secure Tennessee’s place as a world leader in proton therapy.”