Dr. Christopher Walsh measures the location where the IMRT solid compensator radiation beam will hit on patient Gloria Harbridge. Walsh operates the Mid-Rivers Cancer Center. DANA ROMANOFF/THE FREE LANCE-STAR

A Montross cancer center wants insurance companies to provide coverage for its treatment.

By CHELYEN DAVIS

Date published: 10/18/2006

RICHMOND--A legislative commission yesterday heard arguments over whether insurance companies should be forced to cover a particular radiation therapy for cancer patients, but won't make a recommendation until next month.

The therapy--known as "intensity modulated radiation therapy," or IMRT--is offered at the Mid-Rivers Cancer Center in Montross, a clinic established by Dr. Christopher Walsh. IMRT delivers radiation to a tumor in a way that's more concentrated and affects less of the surrounding healthy tissue.

Walsh says it's clearly a better method than conventional radiation for some cancers. But this past spring, health insurance companies--such as Anthem--stopped covering IMRT for breast and lung cancers, saying it wasn't proven to be more beneficial to patients than conventional radiation treatment for those cancers. Several companies, including Anthem, still approve IMRT for use on other cancers, such as those of the head and neck.

Walsh and his local legislator, Del. Rob Wittman, R-Westmoreland, believe breast and lung cancers should be covered, too. So Wittman introduced a bill in the 2006 General Assembly session to mandate that health insurance providers cover IMRT for breast and lung cancers.

The legislature routinely refers mandated coverage bills to a special commission that studies them and makes recommendations on whether the state should require insurance to cover them. Insurance providers in Virginia are currently required to cover 53 different diseases and procedures--the second-highest in the country, according to the Virginia Association of Health Plans.

The special commission met yesterday, and Walsh and about 50 supporters bused down from the Northern Neck to testify that his methods of radiation treatment are better for some patients than conventional radiation, and should be covered again--as they were before Anthem made this decision last year.

"For certain kinds of cancer, IMRT is the only life-saving option," Walsh said. "This is not experimental therapy. Many experts believe it is the new standard of care."

Walsh and Wittman said it's unfair that patients who have the thousands of dollars the therapy costs can receive it, as can patients whose health insurers still cover the procedure, but that those with Anthem cannot.

Date published: 10/18/2006