class action law suit over proton beam coverage

[Guest guest]

>

> Grist for the Mill:

>

> " CANCER GROUP SUES HMOs FOR THERAPY COVERAGE - Cancer Victims for

> Quality Healthcare wants health insurers to pay for proton beam

> radiation therapy for prostate cancer - Brief Article

> Healthcare Financial Management, July, 2001

> Cancer Victims for Quality Healthcare has filed a lawsuit in Los

> Angeles County Superior Court to force five HMOs to cover proton-

beam

> radiation therapy to treat prostate cancer. The five HMOs are Blue

> Shield of California, Cigna Corporation, Health Net Inc., Kaiser

> Health Plan Inc., and PacifiCare Health Systems Inc. "

>

> Fuller

Gregg and I found out about this law suit early in our research. It

was well covered in the media at the time. The result of the suit was

out of court settlements for the plaintiffs. 4 of the 5 insurance

companies have changed their policies regarding coverage of proton

beam for prostate cancer. Kaiser has not. This is because they have

their own treatment facilities. I contacted the law firm involved in

this case and they declined to represent Gregg. Gregg and I are

pursuing legal action with a southern CA law firm, Heipler & Heipler.

The movie " The Rainmaker " , based on the Grisham novel was taken

from the real life and death story of the sister of our lawyer. Her

last hope for treatment for breast cancer was a bone marrow

transplant. The insurance company stalled long enough for her to lose

her battle, and then changed their tune when it was too late. Mr.

Heipler only gives us about a 30% chance of success with Kaiser, but

we may take the odds and see what happens.

Laurel