AG Miyares provides official opinion on proton radiation therapy in cancer treatment

 

Proton radiation therapy is a groundbreaking nonsurgical advanced radiation technology clinically proven to precisely treat tumors with minimal side effects while protecting nearby healthy tissue.

Proton radiation is a different form of radiation than x-rays with very different effects on the human body. However, prior authorizations and insurance denials are becoming increasingly significant barriers to the life-saving treatment.

Attorney General Jason Miyares today issued an official Attorney General’s Opinion, at the request of Delegate A.C. Cordoza, on proton radiation therapy and health insurance coverage. His opinion clarifies that Virginia law does not allow insurance carriers who provide coverage for cancer therapy to deny coverage for proton radiation therapy based on a higher standard of clinical evidence than what is used by the insurance company in making coverage determinations for other forms of cancer radiation therapy.

The Hampton University Proton Therapy Institute is the largest standalone proton treatment center in the United States and has successfully helped more than 4,000 patients battle cancer. It was established in 2010 as a response to Hampton Roads’ high mortality rate of prostate and breast cancer. The Inova Department of Advanced Radiation Oncology and Proton Therapy in Fairfax County is the second proton therapy facility in Virginia.

“The Hampton University Proton Therapy Institute is a standout institution that not only serves Virginians, but also treats people from around the world. They save precious lives. It’s essential that the prior authorization process is streamlined and patient access to proton radiation therapy is expanded and made accessible, so that every patient can get the treatment that is right for them,” Miyares said.

Official AG opinions represent the Attorney General’s analysis of current law based on the Office’s thorough research of existing statutes, the Virginia and United States constitutions, and relevant court decisions.

“I would like to thank Attorney General Miyares for providing the Virginia legal analysis on cancer proton therapy cancer insurance coverage,” Del. A.C. Cordoza said. “This historic opinion will increase access to life saving proton therapy and will prolong the lives of so many cancer patients in Hampton Roads by reducing side effects and improving quality of life during and after treatment. The Hampton University Proton Therapy Institute is doing great work in this field and I’m hopeful that this Attorney General’s Opinion can allow the Institute to serve more Virginians and also address racial disparities in access to high quality cancer treatment.”

Hampton University President Darrell K. Williams said that Miyares’ opinion to expand patient access is a resonant plea for inclusivity and cancer health equity.

“The transformative potential of proton therapy in treating cancer is both remarkable and essential to making this groundbreaking technology accessible to all who could benefit from it. By removing structural barriers and reducing disparities in access, we pave the way for a future where every patient, regardless of their background or where they live, can receive the cancer treatment protocol that is right for them,” Williams said.

He added that cancer remains a leading cause of death for Virginians, which makes it a major public health concern.

“With this harsh reality in mind, the Hampton University Proton Therapy Institute is committed to saving lives through cutting-edge research and innovations in cancer treatment. We take pride in our numerous accomplishments in the medical and scientific realms, successfully treating many forms of cancer and making a positive impact in the lives of the people that receive treatment at our facility every day. Beyond advancing innovative cancer treatment, we are dedicated to reducing healthcare disparities in Virginia’s underserved communities. We firmly believe that access to the life-affirming benefits of proton therapy should transcend zip codes. We also believe it is both just and right to provide all individuals, regardless of where they live, with access to the best treatment with minimum side effects and diminishment to their quality of life.”