What you're about to read is known as damage control or crisis communications.
This is done when a company is in the crapper.
CIGNA is in a world of hurt for its crime. Their problems may even have repercussions on the entire rotten Murder By Spreadsheet insurance industry. CIGNA got caught, but this is what they all do.
With luck, some people at CIGNA will face murder or manslaughter indictments. So, what you're going to read, is the CIGNA version of reality. Of course, anyone past kindergarten, anyone following this unspeakable tragedy, knows what's being said by its medical director Jeffrey Kang, is nonsense.
Of course, what the medical director fails to state is that CIGNA did not approve the transplant until it was pressured to reverse itself, and by then, it was too late.
And, never forget, that CIGNA was shamed, kicking and screaming into approving the transplant thanks to you--Kossacks, outraged American citizens, California Nurses and the Armenian community in Los Angeles, who stood up and said, ENOUGH.
And as you read this bullshit self serving garbage, please, please remember Nataline was an insured American citizen.
You think you're insured? Think again.
What happened to Nataline happens across the United States day-in-and-day out. It is the for-profit insurance industry business model. Delay. Deny. Deceive.
Do you want to take action?
Here's how to contact the Los Angeles District Attorney, demand that they file charges against those at CIGNA responsible for this crime.
What follows is an internal CIGNA email which was sent to me. It's from the medical director and was intended as a corporate explanation to CIGNA employees.
You have undoubtedly read or heard the tragic story of Nataline
Sarkisyan, and we know that all of our hearts go out to her family and
friends during this sad time.
Our commitment, as always, is to assure that our members receive the
highest quality health care, and we thought it important to make clear
to all of you that in this case we fulfilled our responsibilities
correctly and with the utmost integrity.
Transplants are an enormously complex and emotional societal issue, in
particular because of the scarcity of organs and the experimental and
unproven nature of some of the treatments involved. In all
circumstances, a completely independent national organization controls
the allocation of organs for transplant based on a number of important
considerations independent of any decision involving insurance
coverage.
What is often misunderstood is that most health benefit plans, whether
public or private, do not cover unproven and experimental treatment
related to transplants or other treatments. Coverage decisions under
these plans are based on the best scientific and clinical evidence
available, often utilizing external experts, without consideration of
cost. At CIGNA, we facilitate payment for more than 90% of all
requested transplants and specifically more than 90% of the liver
transplant requests made to us.
In reviewing requested transplants, we follow certified processes and
evidence-based guidelines published by independent physician and
medical organizations, as well as expert scientific journals. As in
this case, we often accelerate the process if the specific medical
circumstances indicate we should do so. In this case, rather than
going through our standard method of appeal, we went directly to not
one, but two, independent experts in the field who agreed that the
procedure in question, given the patient's particular circumstances,
would not have been an effective or appropriate treatment.
Based on the unique circumstances of this situation, and although it
was outside the scope of the plan's coverage and despite the lack of
medical evidence regarding the effectiveness of such treatment, CIGNA
decided to make an exception. CIGNA did not reverse the clinical
determination that the member's plan did not cover the transplant. In
fact, CIGNA went above and beyond the plan and offered to provide
payment in the event the procedure should be completed.
Because of the nature of this case as well as threatened litigation,
we should expect to continue hearing more about this situation. Due
to patient confidentiality, it is currently not possible for us to
comment on specific accusations, many of which have mischaracterized
our decisions and intentions. Given the pride and commitment that
each of you have for our organization, receiving unfair criticism, as
we have in this case, can be difficult for all of us. We take our
commitment to our members extremely seriously, and we will carefully
guard our reputation in that regard.
At CIGNA, we offer industry-leading quality of care in large part due
to the outstanding work of our doctors and nurses as they work with
our members and provider partners each day – efforts supported by all
of you throughout the organization. As always, we will communicate
with and support all of you in the coming days and weeks, in pursuit
of our shared mission to improve the health, well-being, and security
of the people we serve.
Jeffrey Kang, M.D., M.P.H. David Cordani
Chief Medical Officer President
CIGNA HealthCare CIGNA HealthCare
Wendell Potter
Corporate Communications
CIGNA Corporation
1601 Chestnut Street, TL16B
Philadelphia, PA 19192
215.761.4450
215.761.5351 (private fax)
wendell.potter@cigna.com
Here again is how to contact the Los Angeles District Attorney, demand that they file charges against those at CIGNA responsible for this crime.