A nine month old by the name of Connor Richardson has an aggressive brain tumor, received a letter from his family insurance company explaining why they couldn’t continue to cover him..
According to Rawstory:
A 9-month-old boy with an aggressive brain tumor received a letter from his family’s insurance company explaining that treating the cancer would be too expensive and therefore “not medically necessary.”
Connor’s father — retired NYPD officer Wayne Richardson — told The Daily Beast’s Michael Daly that at 7 months old, his son had a frightening crying jag late one night. The baby’s eyes popped open, wide and staring.
‘Dear Connor Richardson,” the letter said, according to The Daily Beast, “As HIP Health Plan of New York, we try hard to provide you with access to quality health care services that meet your needs. When we decide to deny coverage for treatment or service, we want to make sure you know why.”
“Not like a regular baby, like when somebody dies,” Richardson said.
Connor was diagnosed with a rare aggressive teratoid rhabdoid brain tumor that was blocking blood flow to his spine. Doctors removed the tumor, but the cancer returned.
St. Jude’s Children’s Hospital in Memphis, TN opted to place the baby on a combination of four drugs plus an experimental medication in a desperate bid to save his life.
“He’ll die if you don’t do it,” said Richardson.
However, the family’s insurer has deemed that the lifesaving treatment is “not medically necessary” and warned Connor, “If you decide to have this service you may have to pay it yourself.”
the company explained to Connor — as if he were his own child:
“Your child is a 9 month old boy who was diagnosed with a high grade brain tumor. Your child was treated with surgical removal of his tumor at Stony brook Hospital. After your son was discharged you enrolled him in a clinical trial at St. Jude’s hospital. The principal investigator has requested medications including methotrexate, cisplatin, cyclophosphamide, vincristine in combination with an investigational medication, alisertib. This combination of medications is not the standard of care for this type of cancer, and is considered experimental and investigational at this time, as evidence-based guidelines do not exist to confirm its effectiveness for his brain tumor. Therefore, this request for clinical trial treatment at St. Jude’s hospital is not medically necessary and is denied.”
Because the treatment is a clinical trial, it may not reverse the cancer’s growth. Therefore, HIP sees no reason to pay for it.
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