This just in from the Honolulu Advertiser. Seems a woman diagnosed with hepatitis and given thirty days to live was denied the liver transplant she needed by Hawaii Medical Association (HMSA), the largest insurer here in the Islands.
The reason she was denied care after the jump ...
...her insurance carrier, Hawaii Medical Service Association, denied her coverage for a liver transplant she needed to survive because three toxicology tests showed trace amounts of cannabis in her system.
According to Reyes' attorney, Ted Herhold, with San Francisco-based Townsend and Townsend, toxicology tests from June 14, July 3 and July 14 were the sole final basis for HMSA's final denial of coverage for the 51-year-old mother of five.
Reyes' mother, Noni Kuhns, and Kimberly's husband, Robin, acknowledged HMSA's decision was based upon a failure to comply with the insurer's policy forbidding drug use. However, both claimed after the claim denial that neither HMSA nor her doctors notified Kimberly or the family of HMSA's apparent policy on drug use.
I'm not sure how many other insurers out there have a provision by which they can deny coverage based on drug use. And I can understand why an insurer might be hesitant to approve an organ transplant for an unrepentant meth addict. But that "trace amounts of cannibis" can become a death sentence is not only a travesty of justice, it's a patently transparent excuse by which an insurer can deny expensive treatment to a deserving patient (a mother of five(!) who has paid her premiums). This is where the insanity of the war on drugs meets the insanity of our health care system.
I wonder whether HMSA's policy covers alcohol use; I would assume that a candidate for a liver transplant is in far more danger from drinking the legal drug than she would be from smoking marijuana.
Just in case anyone wants to dash off a note to HMSA (I've done so; they're my insurer, and yes, once in a blue moon I smoke marijuana. I sincerely hope that should the day come that I need to get to an emergency room, I won't be denied coverage because I took a toke while watching the latest Miyazaki film), here's their info:
HMSA Center
818 Keeaumoku St.
Honolulu, HI 96814
Phone: (808) 948-6111
Fax: (808) 948-5567
incidents@hmsa.com
Kimberly Reyes died on July 27 in a Hilo hospital sixteen months after her diagnosis.