Monday, October 5, 2009

Shameless Corporation of the Week Award

This weeks Shameless Health Care Corporation is Cigna. This story involves two identical twin girls who developed cancer at age 4. They were treated with total body radiation and chemotherapy which damaged the hypothalamus and pituitary gland. Those glands are responsible for growth and their endocrinologists determined that they needed growth hormone at age 7 when the damage was evident. Growth hormone is only needed until the bone endplates have developed.

During this time, their dad's employer switched insurance carriers from Aetna to Cigna. Cigna did a medical review and determined that the girls simply had "idiopathic short stature" and did not need growth hormone. Despite letters and "peer to peer" consults with their endocrine specialists, Cigna would not budge and refused to pay for the drug they were receiving.

According to the girls mother, the proactive physicians are very used to dealing with insurance companies and managed to get the drugs free from the manufacturer as a "bridge" because stopping growth hormone stops growth.

Cigna even denied that there was a 2nd twin and they have denied that the parents have appealed the decision.

Cigna certainly wins our award this week for its reckless, shameless behavior as a health insurance company.


Katie said...

My first thought was, it is pretty damned shameless to call their short stature idiopathic when its etiology seems to be pretty conclusively explained.

My second thought was, wait, I don't know anything about this case or how severely the girls' growth was affected or how normal their growth was before the cancer or anything else, and I'm not a doctor anyhow.

My third thought was, why on earth should it be up to someone who's also not a doctor, who has no physician-patient relationship with these kids, whose job it is to deny treatment because their fiduciary duty is to their shareholders--why should they have the right to make this decision?

Which is of course exactly the point.

Kellie said...

Unbelievable that they can also deny the existence of a living individual with a birth certificate who they can see in person alive and breathing.

jobb said...

If the National Health Plan is passed to give such insurance companies the oversight of the health of EVERYONE in the country, with no alternative choice, what a mess we will all be in. We need the public option and we need the oversight of independent medical experts.

Cary said...

Wow, Cigna's having quite a year. I'm sure you've seen the articles about Dawn Smith (?)

Toni Brayer MD said...

Katie: Right on.

Cary: There is no end to shameless health care corporations and my award will undoubtedly have many recipients in the future. Cigna certainly ranks right up there!