A health insurance provider is under fire for refusing to pay for a treatment that might save a young boy's life.
Five-year-old Kyler VanNocker of Pennsylvania is ailing from a lethal childhood cancer known as neuroblastoma, and his insurer HealthAmerica is refusing to pay for the only known treatment that can save his life, reports Ronnie Polaneczky for the Philadelphia Daily News.
In response, VanNocker's parents Paul and Maria have filed a lawsuit against the insurance company claiming its alleged decision to refuse coverage for their son is based on "a biased, self-serving misreading and misinterpretation" of his medical records and their own policies.
"These companies have to be brought to the courthouse to get them to do the right thing," David Senoff, the attorney representing the VanNockers told the Daily News, suggesting the five-year-old will die if he does not receive care.
HealthAmerica's apparent rationale is that the efficacy of the treatment in question, MIGB therapy, has not been approved by the Food and Drug Administration and is not substantiated strongly by "peer-reviewed" medical literature.
But the lawsuit points out that two treatments meeting neither of these criteria had been offered to VanNocker by the same insurance company in 2008. Both were successful in averting severe health consequences for the five-year-old.
VanNocker's oncologist told the Daily News last year that the MIGB therapy is the "standard of care" for neuroblastoma and "the results are often very good."
His health problems have re-surged, and the VanNockers allege HealthAmerica is unjustly denying necessary care their son is entitled to under their insurance plan.
Kendall Marcoccia, a spokesperson for HealthAmerica, declined to comment.
Eliminating loopholes that allow insurance companies to deny benefits to customers with pre-existing conditions is a key component of the Democratic health care legislation that's been approved by the House and Senate but remains in limbo.
HealthAmerica is headquartered in Harrisburg, Pennsylvania and serves employees of roughly 11,000 organizations across the state, according to the database ZoomInfo.
On MSNBC's Countdown with Keith Olbermann on Tuesday evening, the first 'Quick Comment' gets right to the point, and as Olbermann points out, "The little picture from health care reform remains much bigger than the big picture."
"Kyler Van Nocker has cancer," Olbermann explains. "It was in remission, it's back now. The doctors have a do or die treatment that his insurance company considers investigational/experimental, so it will not pay for it."
"Just a coincidence that the latest therapy for which it will not pay costs $110,000 for two treatments."
Kyler's father Paul attempted to appeal HealthAmerica's decision, and that appeal was denied. "They have a plan for Kyler," says Paul angrily. "Their plan is for him to die."
"Fortunately," Olbermann continues, "Kyler Van Nocker's hospital is giving it [treatment] to him free while he sues HealthAmerica."
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-- Sahil Kapur contributed to this report