A cellist in distress is denied by US health system

Zoe Keating, the most followed cellist on Twitter, withdrew from performance two weeks ago to look after her husband, who has fallen seriously ill.

Things are not going well. Here’s what Zoe has posted in the last hour:

On May 13 an MRI found 20 tumors in my husbands brain. On May 15 he could barely breathe and was in a lot of pain. A CT scan that day revealed he had a softball-sized tumor in his lung, tumors in his other lung, his liver and possibly his bones. On our way home from the imaging center our primary care doc called and told us to turn around and get to the hospital right away. My husband was admitted and they promptly removed more than a pint of fluid from his lungs, which helped him breathe better. We were there for 6 days while they performed a bratheotomy, did more scans, gave him drugs to stop his brain from swelling and administered emergency chemo.

Today I got a letter from Anthem Blue Cross regarding his hospital stay:

“Coverage for the requested service is denied because the service does not meet the criteria for “medical necessity” under your description of benefits. To assist our Medical Director in making this decision, we have put a process in place to send all information about the service to a clinical reviewer with appropriate credentials. Based on their opinion, we have determined that covered for the requested service is denied. Our Medical Reviewer Layma Jarjour MD has determined we cannot approve your hospital stay for cancer. We do not have enough facts to show that it was medically necessary. ”

Anthem is owned by WellPoint. Did you know CEO Joseph Swedish earned almost $17 million during his first year on the job. Now you know how they can afford to pay him.

If you have advice for Zoe in this dire predicament, please post them on her Facebook page.

UPDATE: Media coverage has just started to roll here.