MEASURE TO IMPROVE INSURANCE COVERAGE FOR CANCER TREATMENT BECOMES LAW

Senator Cain’s bill requires equal coverage for oral and IV cancer treatment

AUGUSTA— A bill sponsored by Democratic Senator Emily Cain of Orono to improve insurance coverage for cancer treatment became law on Tuesday without Governor LePage’s signature.

“Whether anti-cancer medication is in pill form or via an IV, it is still anti-cancer medication and should be treated the same by insurance companies,” said Senator Cain. “This law will ensure patients are not unfairly burdened simply because their treatment comes in a different form.”

The new law will level the playing field for insurance coverage by requiring that health insurance companies cover anti-cancer medication taken in pill form in the same way they cover other chemotherapy treatments.

Currently, insurance companies view intravenous cancer treatments as medical treatments with standard copays while oral anti-cancer medications are treated as prescriptions and patients are required to pay higher copayments as well as a percentage of the drug’s cost.

Even for well insured patients, out-of-pocket costs for oral anti-cancer drugs are extremely high, ranging from hundreds to thousands of dollars per month, compared to intravenous treatments that usually require just an office co-pay of no more than 30 dollars.

“Orally-administered chemotherapy is becoming more available and this law will eliminate a barrier to essential access for hundreds of Maine patients and their families who are now paying thousands of dollars out of pocket for life-saving medicine that should be covered by insurance,” added Senator Cain.

The bill, LD 627, “An Act Related to Orally Administered Cancer Therapy,” will take effect 90 days after the Legislature adjourns.

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