HARRISBURG – A new law will require insurance companies to cover medications and treatments prescribed to patients facing Stage IV metastatic cancer, according to Senator Judy Ward (R-30), who sponsored a companion bill in the Senate.
In current practice, insurance companies may limit coverage for prescriptions or require patients to try other insurance-mandated treatments before covering advanced treatments prescribed by a doctor. Act 6 of 2020, which was signed into law this week, will prohibit insurance companies from excluding or limiting drugs for patients if the drugs are approved by the Food and Drug Administration and consistent with best practices for Stage IV metastatic cancer treatment.
The law goes into effect in 60 days.
The legislation was based on the Fair Access to Cancer Treatment Act, a bill introduced by Ward and Representative Kerry Benninghoff (R-171) last year. Eight other states have already enacted similar laws to protect cancer patients.
“Critical medical decisions for these vulnerable patients should be made between the family and the physician – not insurance companies,” Ward said. “The healthcare needs of Stage IV cancer patients are extremely urgent, and any delay in treatment could have terrible consequences. I am thankful that these patients and their families will no longer have to worry about the prospect of coverage being denied for treatments they desperately need.”
Organizations supporting the new law include the American Cancer Society Cancer Action Network, International Cancer Advocacy Network, Prostate Health Education Network, Pennsylvania Prostate Cancer Coalition, Community Oncology Alliance, Pennsylvania Society of Oncology & Hematology, National Organization for Rare Disorders, American Society of Clinical Oncology, Pennsylvania Society of Gastroenterology, Susan G. Komen For the Cure Northeastern Pennsylvania, Malecare: Men Fighting Cancer Together, LUNGevity, and the Pennsylvania Medical Society.
CONTACT: Cheryl Schriner (717) 787-5490