An Oklahoma City woman named Orrana Cunningham was denied coverage by Aetna for proton beam therapy when she was battling cancer in 2014. She died less than a year later from a viral infection.
Proton beam therapy differs from normal radiation in that it targets only cancerous cells. Other tissues on the way to the tumor remain unharmed. It is particularly useful for those whose cancer is near sensitive areas, such as the spine or brain stem, where normal radiation can carry a risk of damaging those tissues.
Cunningham's tumor was near her brain stem. Yet an Aetna doctor deemed the procedure "experimental" and two other doctors backed the ruling. In papers filed in the lawsuit, one Aetna doctor complained of the sheer volume of filings they deal with every day. This past Monday, a jury ruled against the insurance company, ordering them to pay $25.5 million to Cunningham's family.
Jurors order Aetna to pay more than $25 million to the family of an Oklahoma City woman who died a year after the i… https://t.co/n2hZxLSG9s— AP Central U.S. (@AP Central U.S.)1541890326.0
The family's attorney, Doug Terry, argued that Medicare covers proton beam therapy outright, and questioned why the insurance company considers the treatment necessary for a 65-year-old patient and experimental for a 54-year-old.
“The thing I tried to illustrate to the jury is that proton therapy is not a new, experimental technique, like Aetn… https://t.co/qXYpqa3Fca— Inner Dream To Outer Form (@Inner Dream To Outer Form)1541895507.0
Andrew L. Chang, an oncologist and radiation expert was one of the star witnesses in the case. He stated:
"The thing I tried to illustrate to the jury is that proton therapy is not a new, experimental technique, like Aetna wants to claim. Proton therapy is a well-established treatment for cancer and has been for decades."
While Cunningham started the lawsuit against Aetna, she didn't live to see its result.
However, her husband, Ron, stated:
"My wife, her goal, was to make this fight. Her comment was, 'If we can save one person and stop Aetna from doing what they traditionally do on every claim, it was worth the battle.'"
People lamented the state of health care in the United States.
@APCentralRegion @AP No amount of money will bring this woman back to her family. $25 million is probably a drop in… https://t.co/e3Po2aaLJ6— Laura Bradley (@Laura Bradley)1541897338.0
@LauranLafayette @APCentralRegion @AP If they have to keep paying out 25 million dollar chunks people will get thei… https://t.co/PtceZErxK5— Joe (@Joe)1541897524.0
@APCentralRegion @AP This is exactly why US healthcare costs are among the highest in the world and patient outcome… https://t.co/u7AJKODi4z— Ang (@Ang)1541899620.0
@APCentralRegion This reminds me of the saying recently "payable by fine just means it's legal for rich people." Am… https://t.co/C7xxw2EvZs— Ânthoný (@Ânthoný)1541915873.0
Others shared their own insurance stories.
@APCentralRegion @AP Blue Cross Blue Shield just denied my husband this exact treatment for his cancer.… https://t.co/BgVnJtME4A— Mozzr (@Mozzr)1541898043.0
@Justitia2018 @APCentralRegion @masg66 This company denied my Sister in law her infusion drug. They made her do a a… https://t.co/SF3a72FO6A— outdoorvoice (@outdoorvoice)1541909722.0
@APCentralRegion This. Every year my own insurance provider dumps me because of a possible pre-cancer condition. E… https://t.co/1u89JJD9ni— The Realtor You Trust (@The Realtor You Trust)1541935118.0
@APCentralRegion @AP Everything is "Experimental" to the Drs at Aetna! I've got Deterioration of the Spine...had 4… https://t.co/e9hzba4PLE— Denise Childs-Wisley (@Denise Childs-Wisley)1541930500.0
@APCentralRegion @AP ...only to be "Denied" "Experimental Procedure". I was tintevly scheduled for Spinal Vertebrae… https://t.co/fEPFGtXaJv— Denise Childs-Wisley (@Denise Childs-Wisley)1541931738.0
@APCentralRegion @AP People will die, or have permanent physical disabilities, due to Aetna making a rash, unsourced decisions!! 😠— Denise Childs-Wisley (@Denise Childs-Wisley)1541931962.0
We hope Orrana Cunningham's death won't be in vain, and no other Aetna policyholder will go through what she did.