SB1274 Attacks Hawaii’s Medicaid Citizens, Insurance Companies Taking More Rights From Hawaii

Posted on | January 21, 2012 | No Comments

www.facebook.com SB1274 Attacks Hawaii’s Medicaid Citizens, Insurance Companies Taking More Rights From Hawaii Let’s say that you or a family member is diagnosed with a treatable, but potentially life-threatening condition, and your doctor recommends an approach that your health plan says is “experimental” (not yet FDA-approved). bone marrow transplants are “experimental” for nearly everything, as are most treatments for cancer. … Many life-threatening conditions such as “idiopathic pulmonary fibrosis” (“conditions” because “idiopathic” means no known cause) for which there have not been clinical trials, and diseases such as mucinous adenocarcinoma of the appendix, that are so rare (1:10000000) there will never be clinical trials, so any treatment is “experimental.” I have litigated all of these conditions with health plans. I had one case where the study establishing the treatment as the gold standard came out during the case. HOW DO YOU FIGHT THE DENIAL BY YOUR HEALTH PLAN? ou presently have the right to a hearing before a 3-person panel, including a doctor, plan administrator, and Ins. Division attorney, to decide whether your health plan was reasonable in denying you a treatment your doctors recommend (or whether it is specifically excluded by the plan language). You have the right to hire and have …experts and any other witnesses testify on your behalf, and to hire an attorney to prepare your case and represent you. Because your case is part of a larger …
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