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

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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 (1:10,000,000) 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 enforcement scheme to prevent "managed care abuses" you don't have to pay for these costs - the Insurance Commissioner will order your health plan to pay for them.
IF SB 1274 PASSES in its present form, YOU CAN FORGET ABOUT THESE RIGHTS.
Life as we know it in Hawaii (in health care) IS OVER.

In place of our present rights, under SB1274 as it stands, if you appeal a denial of coverage, it will be sent to a doctor in Minnesota or North Carolina to decide whether your plan's denial was reasonable. That doctor will be expected to apply our law (WHICH, BTW, MEDICAID DIRECTOR KENNY FINK IS TRYING TO CHANGE DRAMATICALLY ...TO DISADVANTAGE YOUR CASE). If that doctor makes a mistake, TOO BAD. YOU HAVE NO RIGHT TO APPEAL (which you now have - I have had to appeal 4 cases, won 2, 2 not yet decided)
BTW, my partner and I have won or settled favorably 80% of the cases.
Where did we get all of these health plan cheerleaders in our government? $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
DON'T LET THIS HAPPEN TO YOU AND YOURS. CALL YOUR SENATOR. CALL YOUR REPRESENTATIVE TODAY AND PROTEST THE REPEAL OF OUR RIGHTS!

Category:

Nonprofits & Activism

Tags:

• health care
• hawaii
• reform
• sb1275
• neil abercrombie
• Shan Tsutsui
• Hanabusa
• Medicaid
• health
• Companies
• sicko

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