Insurance company says infant’s brain cancer treatment ‘not medically necessary’

NEW YORK (WHDH) — A New York family is working to raise the money for a 9-month-old baby’s brain cancer treatment after his family says their insurance denied coverage.

The Daily Beast reports that the issue began when little Connor Richardson was just 7 months old and diagnosed with a teratoid rhabdoid tumor in his brain. Connor underwent two surgeries to remove the tumor, but follow-up exams showed that the tumor returned and the cancer had spread to his spine.

Connor’s family sought medical treatment for the infant at St. Jude Children’s Research Hospital. However, Fox News reports that Connor’s father, Wayne, said he received a letter saying his insurance would not cover Connor’s treatment because it was not “medically necessary.”

According to Wayne, the letter read in part, “The principal investigator has requested medications including methotrexate, cisplatin, cyclophosphamide, vincristine in combination with an investigational medication, alisertib. This combination of medications is not the standard of care for this type of cancer, and is considered experimental and investigational at this time, as evidence-based guidelines do not exist to confirm its effectiveness for his brain tumor. Therefore, this request for clinical trial treatment at St. Jude’s hospital is not medically necessary and is denied.”

Wayne told the Daily Beast that he plans to contest the denial, and that without the treatment, Connor would die.

St. Jude’s Children’s Hospital provides its services at no charge to families who cannot afford to pay for treatment. But Wayne points out that by his insurance denying coverage, they are taking away money the hospital could otherwise use to help other children.

“You’re taking away from them and their research … because the insurance doesn’t want to pay,” he said.

Connor’s family has created a GoFundMe page to help raise funds for the family as they work through his illness.

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