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New Report: More Than 60 Percent of Patients Seeking Proton Therapy Are

Initially Denied by Nation's Insurers

Alliance for Proton Therapy Access launches grassroots campaign calling for state insurance
commissioners to fix broken insurance process.

Washington, DC, May 17, 2018 --(PR.com)-- Today the Alliance for Proton Therapy Access released a
national report - Cancer Care Denied: The Broken State of Patient Access to Proton Therapy - revealing
the heavy emotional and financial burden that many cancer patients endure when trying to get their
insurer's approval for physician-recommended proton radiation therapy. The report calls on insurance
commissioners in all 50 states to adopt and enforce the principles of a Cancer Patients' Timely Treatment
Bill of Rights and hold insurers accountable for providing fair, timely, and transparent access to cancer
treatment.

According to patient data provided by several proton therapy centers, nearly two-thirds (63 percent) of
cancer patients aged 18 to 64 whose physicians recommend proton therapy as the best course of treatment
for their disease are initially denied by their insurer. The report reveals that patients and their physicians
are sometimes successful in reversing the initial denial, but time spent waiting - and delaying treatment -
averages nearly three weeks (13 working days). In the end, proton therapy is denied more than four times
out of ten (42 percent) and it takes an average of more than five weeks (27 working days) to receive that
final denial.

“When dealing with the enormity of a cancer diagnosis, private health insurers are adding undue physical,
emotional and financial stress on patients. They are denying payment, dragging patients, their families
and their doctors through lengthy appeals processes, and delaying access to treatment - seemingly in a
systematic and intentional manner,” said Daniel E. Smith, Executive Director of the Alliance.
“Unfortunately, delay and deny is a common practice for insurers, signaling an urgent need for solutions
that hold them accountable.”

The Alliance is launching Cancer Care Denied, a grassroots campaign to shift the balance of power and
give physicians and patients more say in cancer care. They are calling on insurance commissioners in all
50 states to adopt and enforce principles of a Cancer Patients' Timely Treatment Bill of Rights. The Bill
of Rights calls for:

· Fair, timely, and appropriate access to doctor-recommended cancer treatment;


· Enforcement mechanisms executed by insurance commissioners, including automatic approvals if
insurers fail to meet timelines and meaningful fines for repeated failure to provide fair, appropriate
approvals; and
· The same rights for cancer patients covered by employer self-funded plans.

The failure of insurers to abide by these simple principles imposes tremendous physical and financial
stress on patients. The Alliance's report includes detailed accounts from a number of cancer patients
affected by the disproportionate power wielded by health insurers over patients and their physicians,

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including:

· Linda Thomas, who was initially denied, had no choice but to enter into a frustrating, confusing and
unfair appeals process before her insurer was finally forced to pay for her treatment.
· Vivian Heckman, a lung cancer patient who paid more than $100,000 out of pocket after her insurance
company refused to cover her proton beam therapy, said, “My family will recover from the financial
hardships of paying out of pocket for the therapy; however, there are many more patients without the
financial means to fund their own care and who are dependent on their insurer and have nowhere else to
turn.”
· When diagnosed with a brain tumor at age 23, Brent Neise's proton therapy treatment was denied by his
insurer despite the risks alternative treatments posed to his healthy brain tissue and long-term health.
While fighting the insurer through the appeals process, his care was delayed approximately six weeks.
· Mike Hagy, an oral cancer patient, was denied proton therapy by his insurer and opted to move forward
with traditional radiation because he didn't want to wait any longer to begin treatment. He suffers from
side effects including weight gain and a thyroid condition that will require lifelong medication therapy.

“By adopting and enforcing common-sense principles, state insurance commissioners can take an
important step toward repairing the broken system cancer patients face when they and their doctors are
fighting for the best chance at survival and the highest quality of life,” added Smith. “Cancer patients
should be fighting cancer, not their insurance companies.”

Proton therapy is an FDA-cleared treatment, often approved for pediatric and Medicare patients, that
allows physicians to precisely control and conform the bulk of its cancer-fighting proton energy field on
cancerous cells, thereby minimizing extraneous radiation dose to healthy tissues, preserving organ
function, and potentially reducing harmful side effects. Proton therapy is medically necessary for many
patients suffering from a variety of cancers.

The Alliance is hosting a Facebook Live event today at 3:00pm ET to discuss the report and their new
Cancer Care Denied campaign. To view the event, please visit the Alliance's Facebook page.

About the Alliance for Proton Therapy Access


The Alliance for Proton Therapy Access is an advocacy organization comprised of a growing community
of patients, families, caregivers, physicians, and industry partners working together to make sure all
cancer patients seeking proton therapy receive fair and timely payment decisions from their health
insurers. The Alliance is governed by a Board of Directors made up of patients, physicians and industry
partners. Sign up to be an advocate and learn more about the Alliance at allianceforprotontherapy.org.
Follow the Alliance on Facebook and Twitter.

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Contact Information:
Alliance for Proton Therapy Access
Ellen Almond
703-548-0019
Contact via Email
http://allianceforprotontherapy.org/

Online Version of Press Release:


You can read the online version of this press release at: https://www.pr.com/press-release/753996

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