Albany Law School's Health Law Clinic successfully appealed a crucial insurance denial for a client with terminal, irreversible, primary brain cancer.
On Sept. 6, 2007, the Clinic submitted the appeal for insurance coverage of the cutting-edge treatment Avastin/CPT-11-known generically as Bevacizumab and Irinotecan. Six days later, Empire Blue Cross approved the treatment, finding it "medically necessary," and will provide coverage for one year of life-prolonging treatment.
The appeal included a cover letter requesting an expedited appeal, the client's affidavit, an affidavit from the client's physician and research studies demonstrating the proven benefits of this treatment.
Click here to view these documents.
Second-year law students Charles Dunham IV and Laura Kenney recently won a case that forced United Healthcare to pay for a 20-year old cancer patient's Rituxan treatment, a decision that may impact some 8,000 Americans who are diagnosed each year with Hodgkin's disease.
On Feb. 1, 2007, the Albany
Times Union wrote an article about the victory.
Click here to read the story.
The case was also featured on WAMC-FM, a Albany, N.Y. NPR affiliate. To listen to WAMC story,
click here and then click on "MP3."