09.01
CIGNA Healthcare killed Nataline Sarkisyan in 2007 by denying her a liver transplant. She was 17 years old.
Nataline Sarkisyan’s father made desperate public pleas for CIGNA, her insurance provider, to approve the operation. After more than 100 protestors demonstrated in her family’s favor, the company agreed to pay for the procedure. But it was too late, and Nataline died hours after CIGNA conceded.
According to Emory Healthcare, a liver transplant costs between $100,000 and $400,000. In the third quarter of 2007, CIGNA reported a profit of $298 million and a gross revenue of $4.14 billion. In that same year, CIGNA’s PAC spent about $375,000 during the election cycle, of which about 62% went to Republican candidates.
CIGNA’s CEO H. Edward Hanway, has enjoyed an average annual income of $15.26 million per year.
Let’s never forget Nataline and the others like her who health insurance companies have killed.
More on Nataline Sarkisyan and CIGNA:
Nataline’s story in The Guardian.
[...] From MoveOn.org: CIGNA Ready To Kill Again Category: Health Insurance Victim / Tags: no tag / Add Comment [...]
This is from Cigna
The Nataline Sarkisyan case was tragic for all involved and raised many issues about coverage of experimental treatments and scarcity of organs needed for transplants.
In this particular case, Mr. Sarkisyan’s self-insured employer was responsible for all costs. As in more than 80% of CIGNA’s business, we were acting as administrators for a self-insured employer. Had the procedure been covered under the plan, the employer would have paid the cost. CIGNA, as the administrator, had no financial stake in the decision. Notwithstanding the type of health plan, CIGNA makes all coverage determinations on the basis of the best available medical evidence, regardless of cost.
The role of the insurer is to make determinations as to whether or not a particular procedure is covered under the member’s health benefit plan. It is always the physician who makes treatment decisions.
Coverage determinations are based on the best available medical evidence. In this instance, the determination that the Sarkisyan’s health benefit plan did not cover the procedure was due to the fact that the procedure was unproven and ineffective in these circumstances. That judgment relied on the opinions of two independent experts as well as the guidelines established by the medical community – particularly those of the American Association for the Study of Liver Diseases and the American Society of Transplantation.
The family challenged our decision-making related to this situation through the courts. On April 16, 2009, the United States District Court for the Central District of California dismissed all of the claims against CIGNA related to the coverage determination. The Sarkisyan’s have not challenged the Court’s decision.
Finally, in the context of health care reform it is important to point out that no health plan – public or private, U.S. or international – provides coverage for procedures that are unproven and ineffective. Neither Medicare or Medicaid nor government-run single payer systems in other countries provide coverage for treatments deemed to be unproven and ineffective – this is particularly true given the scarcity of organs.