Tennessee Governor Bill Haslam (R.) has vetoed a bill that would make coverage for proton therapy mandatory under state employee insurance plans.

Haslam asserted that the bill, passed by both the Tennessee House and Senate, would burden patients with excessive charges from out-of-network providers and put them at risk. The bill was sponsored by physician and senator Mark Green (R.) and representative Bob Ramsey (R.).

“The provider advocating this bill rejected a medically appropriate plan for expanded coverage to instead pursue a political mandate,” Haslam said in a statement. “The state is committed to high-quality care that is medically appropriate and fiscally responsible for patients and taxpayers, but this mandate could put patients at risk and expose them to excessive charges from out-of-network providers.”

If passed, the bill would require the state group insurance program to cover physician prescribed hypofractionated proton therapy under the same aggregate amount as intensity-modulated radiation therapy.

Coverage would extend to patients in a clinical trial or registry and prescribed by a board certified radiation oncologist. Aggregate cost would be required to equal the average cost paid by the state for an entire course of IMRT treatment for the delivery of the same biologically effective dose.

Prior to the veto, the bill cleared way to become law in both the Tennessee Senate and House in votes of 29-1 and 82-13, respectively.

Green and Ramsey have called for a special meeting to consider overriding the veto, a move supported by executive director Scott Warwick of The National Association for Proton Therapy.

“His statement that the bill could 'put patients at risk and expose them to excessive charges from out-of-network providers' is incorrect and misguided,” Warwick told HCB News. “The bill's language, which improves access for cancer patients on the state health plan who would benefit from hypofractionated proton therapy, explicitly states that there will be no additional cost over standard IMRT to the patient, the state, or its insurers. We hope that the Tennessee legislature, who in an overwhelming majority voted in favor of this bill, will reconvene for a special session to override the veto in support of cancer patients across the state.”

Dr. Green, a survivor of colon cancer who did not have the option of proton therapy, says the bill would ensure that others have access to another, and in many cases, more effective alternative to conventional radiation that was not available to him.

“The veto would be unfortunate for those patients whose physician has determined with them that proton therapy is the best remedy,” he told HCB News. “The bill is about creating the dialogue on proton therapy; it’s about protecting the patient-physician relationship. The governor makes the point that this is a mandate. We’re not mandating that business do anything. We’re mandating that the state do something.”

The veto comes as Provision CARES Proton Therapy nears completion of its $100 million cancer-treatment center in Franklin.

The Knoxville-based medical provider expressed its frustration with the government in a statement, saying that such actions block patient and physician input, and place the decision for what should be covered in the hands of insurers who seek to ration healthcare expenses.

“The bill is clearly cost-neutral to the state, the cancer patient, and the insurance company, and places the choice of treatment in the hands of the patient and their physician,” company president Tom Welch said in the statement. “I cannot conceive of a more medically appropriate or fiscally responsible measure than that. The governor’s veto takes away the patient’s choice and hands it to the insurance companies.”

Haslam’s office did not return calls for comment.