A Friday funeral was set for the Northridge teenager who died last week after her insurer refused to pay for a liver transplant and then reconsidered. Meanwhile, the girl's health plan stood by its initial decision Monday.
Philadelphia-based Cigna HealthCare has a record of approving coverage for more than 90% of all transplants requested by its members, as well as more than 90% of the liver transplants, company President David Cordani said in a memo addressed to employees and distributed to members of the media.
Nataline Sarkisyan's request was evaluated on an expedited basis using "evidence-based guidelines published by independent physician and medical organizations, as well as expert scientific journals," Cordani said.
A leukemia patient, 17-year-old Nataline had been in intensive care at UCLA Medical Center for about three weeks after suffering complications following a successful bone marrow transplant Nov. 21, relatives said. She was covered under the policy of her mother, a real estate agent.
UCLA doctors put her on a list for a liver transplant Dec. 6 and a liver became available four days later, the family said. Her doctors told Cigna in a letter that patients in similar situations had a 65% chance of living six months if they received a liver transplant.
But the transplant was not done because Cigna deemed it experimental in Nataline's case and refused to pay for it.
The denial was publicized by the California Nurses Assn., the Armenian community and the Daily Kos blog on the Internet -- a campaign that resulted in telephone calls and e-mails to Cigna urging it to reconsider.
But last Thursday, Cigna made an exception and agreed to pay for Nataline's transplant because of the "unique circumstances of this situation," Cordani said in the memo.
The company authorized the transplant even though it still considered it experimental -- and therefore outside the scope of her coverage -- and "despite a lack of medical evidence regarding the effectiveness of such treatment," Cordani said.
But it was too late. The decision came the day Nataline died after her family decided, in light of her deteriorating condition, to take her off life support.
The family blamed Cigna's delay in obtaining coverage approval for her death and have said they would file a lawsuit.
Cigna's Cordani said in the memo that some unspecified accusations had "mischaracterized our decisions and intentions."
