Dr. Daniel Hurley, a top ear, nose, and throat (ENT) doctor in greater Phoenix, never saw himself as an activist – and certainly not one who would challenge convention in his own field of medicine. But Hurley’s outlook began to change about seven years ago when his basketball-loving teenage son was diagnosed with an unusual condition around both knees – osteochondritis dissecans – and the top sports-medicine doctors advising the family recommended surgery. Hurley was surprised after the successful operation when his health insurer told him they were denying coverage, after the fact. Then he was stunned when he learned the doctor who’d signed off on that denial was not a specialist in his son’s condition, but a pediatrician.
Not only should the physicians who make the decisions be held responsible & accountable, but also all the administrators, CEO, Board & other corporate individuals who created & signed of on the specific system to make these medical decisions.
I am a strong proponent for Universal Healthcare and would like to share these important articles on Facebook and Twitter. Please send these with a link to SHARE. Most people have no idea how bad our healthcare system is. Profit is King. Now Insurers have middlemen to decide what prescriptions will cost. CVS and other huge Pharmacies are making huge profits. The only way any of this will change is to inform Americans.
Anyone who reads this and isn't screaming for reform is dead inside. I applaud Dr. Hurley for telling his story and am glad that I left the payer world almost 20 years ago.
Clearly there should be an independent review board, separate from insurance companies, and crossing specialties should be absolutely prohibited. Allowing insurance companies to police themselves in any way frustrates families, degrades care, and costs lives. Thank you, Dr. Hurley, for your advocacy. Prayers for your improved health. 🙏🏻
One of the most painful and wasteful practices of insurance is requiring a prior authorization. They delay timely care, add cost, increase stress for the patient. That is the antithesis of the Triple Aim. They have us doing prior Auths on meds that cost less than 100 per month. It’s absurd. My HealthSystem had to hire a group of nurses just to do prior Auths for patients - money and expertise that could be better applied to pt care. And the people processing these are not medical. It is a senseless wasteful game yet persists despite the effort of the AMA
Kudos to Dr. Hurley. Since he's on his way to becoming a lawyer, I’d like to speak with him about what he will face when he litigates healthcare denials. It’s a huge challenge to fight insurers who ironically are protected by the ERISA law, which was enacted to protect employees, but has been perverted from its original intent by the courts. But it's well worth the effort.
Dr. Hurley was my ENT and I learned that he passed away recently, so we are without this remarkable human being anymore. He was the BEST ENT I've ever had in my entire life and would perform tests or perform antibiotic treatments that he knew "insurance wouldn't cover" but he was always a proponent of treating his patients, not their policies. The system is BROKEN and the fact that he's the latest in victims of it should be a firm bold, italic, and underscore of how broken it is.
I have been inspired by Dr. Hurley’s story. I am a physician but find myself in a crisis of conscience due to the inequities of the Health Care industry. I now plan to work to mitigate the harms done by insurance companies and hospital corporations in the name of “caring.”
Instead of forcing physicians with common mental health issues into drug rehab, medical boards should include medical review activities in the definition of practice of medicine. It already fits many MPA's definitions (holding out as a physician, making diagnosis or treatment decisions) and would require that these miscreant physicians (some seeking retirement income) have at least some actual expertise in the specialty area.
I have cancer and my story is almost identical. I have Cigna and they are constantly denying my treatment. My oncologist did a peer to peer with EviCore to try and get them to cover my PET scan, the “peer” was and ophthalmologist!! She bargained with my doctor and said instead of a PET scan they would approve a CT, a bone scan, and a brain MRI. These scans led to 2 more MRI’s which I’m sure added up to more than the PET. This needs to be fixed. People who are dying don’t need the extra stress of whether their families will get stuck with gigantic bills or having to deal with the insanity of a doctor with no oncological training telling oncologists what’s best for their patients.
Dr Hurley is a saint to take this on in what could be his last months/years of his young life!!! We all need to help him… What’s ludicrous is that getting the appropriate specialist to review claims is the lowest bar. There should be a third party watch-dog on the insurance companies, one with really sharp teeth!!
Great story. Thanks Wendell. The system makes challenging insurers difficult, which is why so few lawyers are available who devote their resources to this practice. The more we can get people like Dr. Hurley engaged, the better.
Dr. Daniel Hurley I wish you a safe and successful battle. I have had to battle insurance companies on behalf of patient for many years. It is as if health care has become a commodity instead of a right to be free to see doctors you've been referred to, for services that they are qualified to offer and to have a portion of the outrageous prices paid.
Not only should the physicians who make the decisions be held responsible & accountable, but also all the administrators, CEO, Board & other corporate individuals who created & signed of on the specific system to make these medical decisions.
I am a strong proponent for Universal Healthcare and would like to share these important articles on Facebook and Twitter. Please send these with a link to SHARE. Most people have no idea how bad our healthcare system is. Profit is King. Now Insurers have middlemen to decide what prescriptions will cost. CVS and other huge Pharmacies are making huge profits. The only way any of this will change is to inform Americans.
Very much hoping for his survival and continued advocacy. Thank you to all of you fighting the good fight.
Anyone who reads this and isn't screaming for reform is dead inside. I applaud Dr. Hurley for telling his story and am glad that I left the payer world almost 20 years ago.
Clearly there should be an independent review board, separate from insurance companies, and crossing specialties should be absolutely prohibited. Allowing insurance companies to police themselves in any way frustrates families, degrades care, and costs lives. Thank you, Dr. Hurley, for your advocacy. Prayers for your improved health. 🙏🏻
One of the most painful and wasteful practices of insurance is requiring a prior authorization. They delay timely care, add cost, increase stress for the patient. That is the antithesis of the Triple Aim. They have us doing prior Auths on meds that cost less than 100 per month. It’s absurd. My HealthSystem had to hire a group of nurses just to do prior Auths for patients - money and expertise that could be better applied to pt care. And the people processing these are not medical. It is a senseless wasteful game yet persists despite the effort of the AMA
Kudos to Dr. Hurley. Since he's on his way to becoming a lawyer, I’d like to speak with him about what he will face when he litigates healthcare denials. It’s a huge challenge to fight insurers who ironically are protected by the ERISA law, which was enacted to protect employees, but has been perverted from its original intent by the courts. But it's well worth the effort.
Dr. Hurley was my ENT and I learned that he passed away recently, so we are without this remarkable human being anymore. He was the BEST ENT I've ever had in my entire life and would perform tests or perform antibiotic treatments that he knew "insurance wouldn't cover" but he was always a proponent of treating his patients, not their policies. The system is BROKEN and the fact that he's the latest in victims of it should be a firm bold, italic, and underscore of how broken it is.
I have been inspired by Dr. Hurley’s story. I am a physician but find myself in a crisis of conscience due to the inequities of the Health Care industry. I now plan to work to mitigate the harms done by insurance companies and hospital corporations in the name of “caring.”
Instead of forcing physicians with common mental health issues into drug rehab, medical boards should include medical review activities in the definition of practice of medicine. It already fits many MPA's definitions (holding out as a physician, making diagnosis or treatment decisions) and would require that these miscreant physicians (some seeking retirement income) have at least some actual expertise in the specialty area.
I have cancer and my story is almost identical. I have Cigna and they are constantly denying my treatment. My oncologist did a peer to peer with EviCore to try and get them to cover my PET scan, the “peer” was and ophthalmologist!! She bargained with my doctor and said instead of a PET scan they would approve a CT, a bone scan, and a brain MRI. These scans led to 2 more MRI’s which I’m sure added up to more than the PET. This needs to be fixed. People who are dying don’t need the extra stress of whether their families will get stuck with gigantic bills or having to deal with the insanity of a doctor with no oncological training telling oncologists what’s best for their patients.
Dr Hurley is a saint to take this on in what could be his last months/years of his young life!!! We all need to help him… What’s ludicrous is that getting the appropriate specialist to review claims is the lowest bar. There should be a third party watch-dog on the insurance companies, one with really sharp teeth!!
How did Dr. Hurley find out that it wasn’t a specialist reviewing his son’s claim?
Great story. Thanks Wendell. The system makes challenging insurers difficult, which is why so few lawyers are available who devote their resources to this practice. The more we can get people like Dr. Hurley engaged, the better.
Ady Barkan is doing this work. We need single payer. https://beaherofund.com/
Dr. Daniel Hurley I wish you a safe and successful battle. I have had to battle insurance companies on behalf of patient for many years. It is as if health care has become a commodity instead of a right to be free to see doctors you've been referred to, for services that they are qualified to offer and to have a portion of the outrageous prices paid.