He was no ordinary patient. And he was ready to fight.
The Big Story
Tue. Nov 7, 2023
Blue Cross and Blue Shield denied payment for the proton therapy Robert “Skeeter” Salim’s doctor ordered to fight his throat cancer. But he was no ordinary patient. He was a celebrated litigator. And he was ready to fight.
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How the Insurance Industry Denies Coverage to Patients
I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals. Nearly everyone said the same thing: Great idea. But almost impossible to do.
Insurers’ denial rates — a critical measure of how reliably they pay for customers’ care — remain mostly secret to the public. Federal and state regulators have done little to change that.
Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your case.
Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.
After a college student finally found a treatment that worked, the insurance giant decided it wouldn’t pay for the costly drugs. His fight to get coverage exposed the insurer’s hidden procedures for rejecting claims.
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A 2008 city law intended hotels used as primary residences to be preserved as safety-net housing. But with little enforcement, some landlords had turned their buildings into tourist hotels.
The all-white judges of Louisiana’s 5th Circuit Court of Appeal systematically ignored thousands of claims from prisoners, most of them Black, who said they had been wrongly convicted. Efforts to expose the decadelong injustice went unheard.
The court’s ruling on United States v. Rahimi could clarify an earlier decision on guns. Or it could take away one of the best options to protect domestic violence victims. In states like Tennessee, the consequences could be deadly.
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Tim Dunn’s public policy groups have helped ensure that tax hike language is attached to school bonds in the state. Now, that language is being used to undercut support for a bond in his hometown of Midland.
It would be the largest repatriation by far at an institution that holds more than 9,000 ancestral remains and has lagged behind in returning its holdings under the Native American Graves Protection and Repatriation Act.
The devices at their bedsides were lifelines, until they learned the foam inside could break down and make them sick. Now, they’re plagued by illness, lost sleep and worry.
Parents, already shaken by the fatal incident at Oxford High School, lost confidence in the school district when it hesitated to find and acknowledge accountability for the 2021 shooting.
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