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Insurance dispute costs Bridgeport man potentially life-saving treatment
BRIDGEPORT, (WBOY) — For the past two years, a Bridgeport, West Virginia man suffering from cancer has been searching for an operation that could improve his health, but after denials and disputes with his insurance provider, his family says that he may have missed his chance.
A report from NBC News on Thursday night spoke about Eric Tennant, a Bridgeport resident who works at the West Virginia Office of Miners' Health Safety and Training and suffers from a rare cancer found in his bile ducts. He was diagnosed at stage 4 in 2023 and wasn't expected to survive a year, dropping below 100 pounds at one point.
In fall 2024, following nearly two years of chemotherapy treatment, Tennant's wife, Rebecca, learned of a way to potentially aid his condition through a 'relatively new' procedure known as histotripsy, NBC News reported. The procedure would use ultrasound waves to target tumors in Tennant's liver and could potentially extend his life.
His insurance declined to cover the $50,000 treatment.
Tennant is insured under West Virginia's Public Employee Insurance Agency (PEIA), and despite receiving a recommendation for the procedure from his oncologist, PEIA cited the treatment as 'not medically necessary,' NBC News reported.
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After learning of PEIA's denial, NBC News reported that the Tennant family attempted to appeal the agency four separate times, all to no avail. Along the way, they were faced with other roadblocks such as UMR, a subsidiary of United Healthcare that manages PEIA plans through a contract with West Virginia, as well as MES Peer Review Services, a Massachusetts-based company that upheld PEIA's decision in March, saying that histotripsy is 'unproven in this case and is not medically necessary.'
NBC News interviewed the Tennants in April and noted that after it and KFF Health News reached out to PEIA with questions for its story, the agency changed its tune.
PEIA officials told NBC News that the agency had 'consulted with medical experts to further evaluate the case' and that Tennant was now, seemingly out of nowhere, approved for a histotripsy. PEIA Director Brent Wolfingbarger told the outlet that the decision to approve Tennant 'reflects a rare and exceptional situation' and doesn't represent a change in PEIA's overall coverage policies.
Despite the sudden approval, Rebecca Tennant told NBC News that it may be too late. She said that since Eric was evaluated in February, his health has declined significantly, resulting in him having to spend five days in the hospital in late May and early June due to lung and heart complications.
As a result of his health declining, Rebecca told NBC News that Eric is no longer considered a viable candidate for a histotripsy. She said she's hopeful that he will be viable once again after his health improves, but blames PEIA for 'wasting months' of their time.
'Time is precious,' she said. 'They know he has stage 4 cancer, and it's almost like they don't care if he lives or dies.'
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