When I learned about Cigna Insurance Company denying treatment that could potentially save the life of a grandfather with Leukemia, I was shocked and wanted to know more…wouldn’t you? Please take a couple minutes to read the story of Barbara and Phil (Dr. Phil Wolfson). Barbara is the host and producer of GRAND Radio along with many other shows for the RadioActive Network.
It is my hope that you will be mad just like me and take the time to let the folks at Cigna Insurance that their dirty little secret is out. Their executives rake in the big bucks while they deny medical treatment to save lives. Why? because it will cut into their profits.
Delay, deny until they die! The Cigna Call to Arms?
However, the CEO was not the most highly compensated person at Cigna last year.
Cigna-HealthSpring President Herbert A. Fritch received $50.5 million last year, as he exercised stock options that had gained $44.4 million in value since they were granted.
Separately, Fritch was awarded restricted stock and stock options worth $1.9 million during the year, which can provide value in future years if the stock price continues to climb.
The Courant calculates compensation as the sum of salary, bonuses, value gained on the exercise of stock options and the vesting of stock awards, and the value of perquisites, such as the 401(k) match and personal use of the corporate aircraft.
As a result of Obamacare, Cigna is not allowed to deduct the salaries, bonuses, stock awards and option awards it grants employees of any amount past $500,000. Most companies can deduct salary up to $1 million, and bonuses and stock and option awards are not subject to the cap.
The compensation committee wrote that it’s not restricting incentives and pay to its executives because “it believes that shareholder interests are best served by not restricting the committee’s discretion and flexibility in crafting the executive compensation program.”
Cordani’s pay included $1.2 million in salary and a $2.9 million in cash bonus.
The bonuses were based on profit growth, revenue growth, operating expense ratio improvement, and customer perception of the company’s products, services, pricing and providers.
Across the company, profit improved by 5.9 percent, and the operating expense ratio improved by 0.1 percent.
Chief Financial Officer Thomas A. McCarthy received $4.6 million in compensation last year, not including $2.7 million in stock and option awards. His compensation climbed 47 percent.
General Counsel Nicole S. Jones received $8.1 million in compensation last year, not including $1.8 million in stock and option awards.
Barbara and Phil’s Story
According to Barabara Beach, “Phil has been admitted and as you may imagine both of us had the deer in headlights look….the belief of the doctors is that my husband was suffering from an aggressive Leukemia. There was no sleep that night as we talked, cried, hoped, prayed and just roiled with shock. Thursday was more frustration as we began the round of tests (I will spare the grizzly details) and no definitive answers. By Friday, we were given the 95% guestimate that he was suffering from Acute Myeloid Leukemia (AML). Definitive results would not be until mid week next week but the decision between doctor and patient (and wife) was not to wait on beginning chemo, As I write this we begin day three of chemo.
On March 16th, Barbara shared this update: So let me walk everyone through this. God forbid you ever have to refer to this for you or a family member…but it is good to know.
No matter what site you go to from the American Cancer Society to the Leukemia Society and even to the US Government….you are told it is important for you to consider going to a specialty cancer center and also consider a clinical trial in treating difficult cancer cases.
Many of these trials are underwritten by the NIH (National Institute of Health)…aka the government (which I believe is ME! YOU!…the taxpayers) OK just needed to get that part of the picture set up.
Today as we are waiting in a waiting room with many people (we do this 3x a week when we are not inpatient) and we are approached by three folks from the stem cell team, It was explained to us that our insurance (CIGNA) has officially sent the denial letter. (The patient, of course, does not see the denial letter if they are in Houston as it is sent to their home out of State.
The NK cells Phil needs are a part of a protocol. NK is Natural Killer cells. The point is for these cells to wipe out Phils leukemic cells,put him into remission and give him the opportunity to have the stem cell transplant from his sister who is a perfect match. Without remission, they cannot do the stem cell and Phil is chemo resistant…i.e., the chemo is not putting him into remission.
I was told without the insurance approval he could not be treated. I asked about paying out of pocket (everyone knowing full well I cannot write a check for a million plus NOW to get the process started. I was told you could not buy your way into the study if you had insurance, I said REALLY? So a Saudi Prince can come to this cancer center with no insurance but buckets of cash and buy into a study funded by tax dollars? I asked about being a Texas resident….the answer was YES…if Phil were a Texas resident with NO insurance and no assets he would be eligible. (He would have to give up his insurance and be a Texas resident for 6 months…that won’t work he won’t be alive)…WAIT A MINUTE, doesn’t everyone, by law, have to have insurance? So we reward people who break the law and don’t buy insurance by giving them treatments my husband who always did everything legally and by the book cannot have because the insurance (that we are forced to buy) won’t cover him?
I went round and round with the conversation and it kept coming back to …no soup for Phil! At that moment Phil was called back into the exam room and I stayed to continue to beg.
A few moments later the team left and I was sitting there stunned and feeling totally helpless. A hand on my shoulder and I turned to notice the woman sitting next to me….she had heard the entire conversation and she was crying. I was ready to join her.
Phil had heard the whole conversation too…it was a death sentence!
Think about this friends…. We have a PPO through CIGNA and Medicare Part A (you are forced to take Part A when you turn 65). We thought we were well insured.
Insurance companies and Big Pharma have however found many loopholes to deny coverage. One is called “standard of care”. If they determine it is not standard of care…. well no approval for treatment. So why are there clinical trials anyway?
At this point I can feel the blood pumping all through my body…a sort of panic and rage combined!
I asked for a copy of the denial letter and while I am waiting for it (quite some time). I am processing information on CIGNA. Did you know CIGNA has its own PAC (Political Action Committee)….and by law they have to list all the organizations and politicians they have “contributed to”. No wonder nothing ever changes….Insurance companies and pharma and their lobby ensure they are protected…not you and I!
I am then strategizing how I am going to get maximum coverage on what is not just our story but that of so many in hospitals around the country when the team comes back with my denial letter and an announcement that she had just got off the phone and my insurance company will (magically) cover clinical trials (now the hospital will have to resubmit to see if the “medical review board of the insurance company” will cover Phil’s case…just because they cover some doesn’t mean they will cover him). I wonder who is on their medical board…since Dr. K. here at MD Anderson is the top leukemia doctor in the world, who could possibly on their board have better knowledge of Phil’s need?
Since the last submission took the insurance company two months for an answer, which was a denial…most assuredly we will lose Phil before we get another no …or God willing a yes. I asked for this to be expedited…we need this answer in three days or less as they want Phil in the hospital again on Monday.
The tactics of insurance is to delay….patient dies. Deny, patient advocate appeals and by the time something happens the patient is dead.
Delay, deny until they die! The Cigna Call to Arms?
Yes folks, there is a great need for insurance reform….this is a Democrat or Republican issue it is a human rights issue.
You WANT to be a part of a reform before you are against the clock with your loved one.
Beyond this…. it is NOT OK with me or with Phil that we just get him taken care of. I sit in the hospital patient laundry room or waiting rooms with so many other moms,wives,husbands,dads and siblings of people experiencing what we are experiencing…fighting with insurance, homeless because they are also from out of State and can not afford one or two thousand or more a month to rent a place. (Please don’t talk to me about social services …waiting lists are months and months long. Let me tell you about the people suffering of cancer who are living out of their car. I have met them. Phil and I have been close to this moving now nine times since Jan 13th.
$49 million that is what the CEO of CIGNA made last year..ask yourself why. Many of my fellow journalists have asked to interview him and are being refused…ask yourself why!
I am sorry if my situation is interrupting your dinners out, or other daily life activities, but we are out of time. A corrupt insurance company is lying to a medical institution and then following it with denials and delays until my love Phil Wolfson dies.
Yup…a bummer to read when you are having cocktails on the beach or on a cruise. I had that life once too!
Now that I know what people go through I will never be the same. I am a rather noisy and pushy journalist. Still not sure it has done any good since the insurance industry and Big Pharma are such powerful political lobbyists. Our paid representatives even voted themselves out of ERISA (you know the guys who decide on the insurance company or you when you complain). It is a rigged system in favor of those rich enough to buy themselves the best medical care. I watch my husband be denied while rich Princes from Saudi belly up to the bar of services because they have cash.
Wake up America! Vote down Citizens United and demand campaign finance reform!
How would you like to receive this notice from your insurance company know it spells death for your loved one?
We had a new review done with the new request we received from the provider’s office. The NK cell infusions are currently in a Phase I clinical trial. Per the plan language of your group they allow for Phase II or higher clinical trials. So given the phase that the NK cells are currently in it would not be eligible under the plan. I have included a copy of the denial letter.
