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ATLANTA CANCER VICTIM WINS BATTLE AGAINST INSURANCE COMPANY ON COST OF MARROW TRANSPLANT

 ATLANTA CANCER VICTIM WINS BATTLE AGAINST INSURANCE COMPANY
 ON COST OF MARROW TRANSPLANT
 ATLANTA, March 13 /PRNewswire/ -- An Atlanta law firm has won an out-of-court settlement against a large insurance company over the company's refusal to pay for a bone marrow transplant in a patient with ovarian cancer.
 The company said the procedure was experimental and not covered by the woman's health insurance.
 Blue Cross and Blue Shield of Georgia agreed to pay the full cost of the autologous bone marrow transplant (ABMT), said attorney R. Keegan Federal Jr. of Federal, Goetz & Cronkright. The insurance company settled the case three days before the civil action was scheduled for trial.
 ABMT involves the removal of some of a patient's healthy bone marrow before chemotherapy. After chemotherapy, the bone marrow is reintroduced into the body to fight the toxic side effects of the chemicals in the therapy. The treatment is standard for various types of cancers.
 "Insurance companies are using an excuse that ABMT is experimental for ovarian cancer, and therefore doesn't qualify for coverage," Federal said. "The evidence we uncovered in this case, combined with Blue Cross and Blue Shield's agreement to pay the claim in full, indicates that even the insurance companies recognize that this procedure is no longer experimental and has become standard medical care."
 Federal, Goetz & Cronkright represented the widower of an Atlanta woman who underwent the treatment at Northside Hospital last year. The woman's doctor recommended the procedure. But because Blue Cross refused to pay, the patient and her husband were responsible for payment.
 "The hidden tragedy is that there are countless women with ovarian cancer whose doctors tell them ABMT is their last real chance for survival or to prolong their lives," Federal said. "To their shock and dismay, they learn that their insurance company refuses to cover the procedure."
 Patients with enough money can pay for the procedure, challenge the insurance company and hire a lawyer to sue the insurer. "But many women may die because they don't have the resources to take that action," Federal said.
 Federal warns women with ovarian cancer who file for ABMT reimbursement to expect a tough fight with their insurance companies. "Insurance companies are under pressure to contain costs. In cases like this, they're going to be unbending, just to try to save money," he said.
 At a time when Americans are struggling over affordable and adequate health care coverage, Federal's case proves that even those who are insured must fight their insurance companies over reimbursement for certain procedures.
 -0- 3/13/92
 /EDITOR'S NOTE: Questions should be directed to R. Keegan Federal Jr. at 404-872-2000./
 /CONTACT: Jeannine F. Addams of Tarkenton & Addams, 404-231-1132, for Federal, Goetz & Cronkright, or R. Keegan Federal Jr. of Federal, Goetz & Cronkright, 404-872-2000/ CO: Blue Cross and Blue Shield of Georgia; Federal, Goetz & Cronkright ST: Georgia IN: INS HEA SU:


BN-BR -- AT002 -- 7722 03/13/92 10:20 EST
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Publication:PR Newswire
Date:Mar 13, 1992
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