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Committee adopts amendment to create advisory process for rare-cancer treatments including histotripsy
Summary
Senators amended and reported House Bill 622 to create an advisory board to study and recommend coverage for treatments for rare cancers, including histotripsy; the bill avoids mandating immediate coverage and instead sets a quarterly review-plus-report process to give insurers and clinicians a forum.
The Senate Insurance Committee on June 4 adopted amendments and reported House Bill 622, which creates an advisory process for evaluating new and rare-cancer treatments such as histotripsy and directs the board to report its findings to the legislature.
Sponsor Representative Hilferty told the committee that histotripsy — a noninvasive ultrasound ablation technique approved by the FDA and Medicare in some settings — has been denied for some patients by private insurers and managed-care organizations. Rather than immediately mandating coverage, the amendment establishes an advisory board of cancer specialists, insurers and regulators to meet quarterly and issue written reports to the legislature. "There's a compelling case to be made that it is actually less costly than the standard of care," Hilferty said, urging a nimble, clinical review process instead of locking a specific treatment into statute.
Why it matters: Histotripsy and other novel procedures for rare tumors may have different cost and clinical profiles from established surgical care. Sponsors said a standing advisory process can bring treating physicians and insurers together to review evidence and potentially adopt coverage without repeated statutory fixes.
Key amendment and implementation: The committee adopted amendment set 28-25, which instructs the advisory board to meet quarterly and to provide a written report within 30 days of each meeting. The Department of Insurance and Department of Health are members of the working group, and the committee emphasized that the board's recommendations could inform coverage decisions more quickly than returning to the legislature for individual statutory mandates.
Committee action and next steps: The committee adopted the amendments and reported the bill with amendments to the Senate floor. Sponsors and committee members said they expect additional discussions with the departments to finalize reporting timelines and membership.
