Medicare Payments to UCLA Cancer Unit

Transamerica Life is disappointed in the Oct. 13 article “Medicare Bill Controversy Shuts UCLA Cancer Unit.”

As a Medicare contractor, we have a two-fold obligation: to pay only proper claims and to ensure that Medicare monies--our tax dollars--are being used to pay for those medical services defined by the government for inclusion in the program.

It is not the intent of the Medicare law to pay for experimental or emerging therapies. When Medicare is made aware of emerging technology, such as fast neutron therapy, we must first determine the acceptance of the treatment. To do this, we contact other Medicare carriers dealing with the same technology, and we seek the judgment of local practicing physicians and professional medical societies--in this case, the Southern California Radiation Oncology Society. There are only three other fast neutron therapy centers in the U.S. and two of the three Medicare carriers have also determined the treatment to still be experimental and not eligible for payment.

In addition, Transamerica’s Medicare operation did not “change its mind” regarding payment for the treatment after the facility closed on Sept. 28. In fact, we determined the treatment had become accepted by the medical community for certain kinds of cancer and, therefore, we were able to begin paying the claims. This decision was communicated to UCLA verbally on Sept. 5. and again in writing.

DAVID R. CARPENTER, Chairman

Transamerica Occidental Life

Los Angeles