Health Insurance Company Denies Coverage To Baby With Cancer

HIP Health Plan of New York sent a coverage denial letter to a nine-month-old baby, Connor Richardson, on Oct. 11.

Connor suffers from cancer.

The Daily Beast published the letter, which was written to Connor as if he were his own dad and could read:

As HIP Health Plan of New York, we try hard to provide you with access to quality health care services that meet your needs. When we decide to deny coverage for treatment or service, we want to make sure you know why…

Your child is a 9 month old boy who was diagnosed with a high grade brain tumor. Your child was treated with surgical removal of his tumor at Stony brook Hospital. After your son was discharged you enrolled him in a clinical trial at St. Jude’s hospital.

The principal investigator has requested medications including methotrexate, cisplatin, cyclophosphamide, vincristine in combination with an investigational medication, alisertib.

This combination of medications is not the standard of care for this type of cancer, and is considered experimental and investigational at this time, as evidence-based guidelines do not exist to confirm its effectiveness for his brain tumor.

Therefore, this request for clinical trial treatment at St. Jude’s hospital is not medically necessary and is denied.

The baby’s father, retired NYPD Officer Wayne Richardson, told The Daily Beast that Connor was only seven months old when he was diagnosed with an aggressive teratoid rhabdoid tumor, which was stemming the flow of fluid to his spine.

Connor underwent emergency surgery at Stony Brook University Hospital. Connor’s neurosurgeon said he had removed all of the tumor and that no cancer was found in the baby’s spine.

However, when Connor had follow-up treatment at St. Jude Children’s Research Hospital in Memphis, doctors said the tumor had returned and that cancer was growing in Connor’s spine.

Those doctors got Connor into  a clinical trial that involves experimental medication.

However, because the clinical trial cannot guarantee it will save Connor’s life, HIP Health Plan of New York refused to extend coverage.

St. Jude offers its services at no charge, so Connor is going to get his chemotherapy while St. Jude takes the financial loss.

(Source: The Daily Beast, Photo Credit: Facebook)

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