OKLAHOMA CITY -
The power of social media comes to the aid of an
Oklahoma teen fighting her insurance company.
Lorelei Decker says Blue Cross Blue Shield said "No"
to a procedure doctors say is her last hope to beat cancer. Decker launched a
Twitter campaign and now her insurance company has changed its mind.
Decker's battle with Hodgkin lymphoma hasn't been an
easy one. Six months of chemotherapy didn't work. Neither did a bone
Marrow transplant.
"It's rough to say, but this is essentially my last
option," Decker told News 9 on Wednesday.
Decker says doctors at MD Anderson in Houston want to
transplant bone marrow stem cells from her sister. But BCBS told her
procedure wasn't "medically necessary."
"They denied my application a day before [my sister] was
supposed to leave for Houston," Decker said. "We were blindsided. I was
terrified. My family was angry."
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Decker captured the hearts of the city last year, with
a Make-A-Wish stint as Oklahoma City Thunder Coach. She capitalized on that
popularity by using Twitter to take on the insurance company. Within hours, the
Twitterverse was abuzz with #ApproveLorelie.
"Blue Cross Blue Shield has basically put a value on
my life. The money that it will cost to cover the transplant that I need is not
worth my life," Decker said.
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In a statement, Hilarie Houghton Sr. Supervisor of
Public Relations for Blue Cross and Blue Shield of Oklahoma said:
"As a member-owned company, Blue
Cross and Blue Shield of Oklahoma takes all member concerns seriously. We are
committed to protecting our member's privacy and – following state and federal
privacy laws – we are not permitted to disclose details of any individual
member's health care without their authorization.
We have an established medical review process to ensure that our members
receive appropriate, necessary and effective care. In general the process may
include predetermination/preauthorization, an initial review policy
determination by an internal medical doctor, a peer-to-peer review (a
discussion between the member's doctor and a Blue Cross doctor to exchange
pertinent information) and an appeals process that offers a clinical review by
a specialty doctor, often a third party.
BCBSOK respects the roles of our members and their doctors in making treatment
decisions; however, we must adhere to the plan certificates and regulatory
guidelines that direct us regarding coverage decisions, determining what therapies are of proven efficacy, and
evaluation of unusual therapies."
But in Lorelei's case, it seems to have reconsidered.
On Wednesday afternoon Lorelei says Blue Cross and Blue Shield reversed its
decision.
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Cancer
"It's not OK for Blue Cross to approve me now and then
be applauded for what they always should have done," said Decker.
Lorelei's family canceled all their plane reservations
and doctor's appointments and now has go through the difficult and expensive
task of trying reschedule them again on short notice.
Doctors have told Lorelei that this treatment has
about a 30% success rate.
Lorelei Decker says Blue Cross Blue Shield said "No" to a procedure doctors say is her last hope to beat cancer.
