Triumph Over Denial: Securing Lifesaving Treatment for a Brave Cancer Patient

Our 74-year-old client is bravely battling anaplastic thyroid cancer, one of the most aggressive and lethal forms of the disease. Her survival depends on a cutting-edge combination of targeted chemotherapy drugs, Braftovi and Mektovi.

Despite confirmation from her expert physicians about the medical necessity of these drugs, her Medicare Part D plan administrator heartlessly denied coverage.

They callously disregarded the life-or-death stakes, the growing body of peer-reviewed research (including studies co-authored by our client’s own doctors) supporting this treatment’s efficacy, and the unconscionable $33,000+/month financial burden their denial placed on our client.

Beth and I fought this cruel decision with everything we had.

We poured our hearts into arguing that Medicare Part D’s “Anti-Cancer Chemotherapy Regimen” exception requires coverage of medically necessary off-label drugs, especially for rare cancers with limited options. We presented compelling evidence and impassioned pleas on our client’s behalf.

I am happy to report that the judge agreed with us and overturned the plan administrator’s denial!

Our client can now continue her life-sustaining treatment and maintain her hope. I’m so honored to work alongside Beth and play a role in our client’s courageous fight against cancer.

Helping desperate patients access the care they need to survive has to be one of the most fulfilling things an attorney can do. At Norton Health Law, we do it every day.

Authored by Associate Attorney, Vincent W.P. Prior, Esq.