State bill to require insurers cover oral chemo

Legislation introduced in the Ohio Senate would require insurers to pay for oral chemotherapy. Most insurers in the state provide full coverage for chemotherapy administered through IVs or injections because they are considered medical benefits. Oral chemotherapy, on the other hand, is categorized as a prescription drug so insurers charge a copay of up to several thousand dollars a month, reported the Advertiser-Tribune.

The Cancer Treatment Modernization Bill (S.B. 194) would require insurers cover oral chemotherapy at the same rates as intravenous and injectable treatments, the Plain Dealer reported.

Although the bill was introduced last summer, volunteers from the American Cancer Society, which claims that out-of-pocket fees for oral chemo can cost up to $10,000, rallied Tuesday at the Ohio Statehouse and drew renewed attention to the issue. They met with hundreds of lawmakers, urging them to pass the bill, according to ABC6.

The insurance industry opposes the legislation and is concerned it will lead to higher premiums. "We've always been concerned about legislatures trying to address clinical issues legislatively," Susan Pisano, spokeswoman for America's Health Insurance Plans, told the Plain Dealer. "There are a variety of reasons [why], but one of the reasons is that medical practice changes quickly and new information becomes available," she said.

But bill sponsor Sen. Scott Oelslager (R) disagrees with industry claims. "We haven't been able to discover any major cost increases for the insurance companies," he said. "We want physicians to be able to work with the patient and provide what's best for the patient."

To learn more:
- read The Plain Dealer article
- see the Advertiser-Tribune article
- check out the ABC6 article

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