Pool_2

shit than this." Dryfus and Bela were both mouths agape, but Macaluso was on his stride. "Get this, SafeMed of Connecticut, denied a child with spina bifida - that's an open spinal column with paralysis - simple leg braces after corrective leg and foot surgery. We fought with them for two months and meanwhile lost foot position and had to reoperate. In court, they LOST, and were told to pay. They paid for ONE brace. ONE! Two legs, one brace. Back to court, they lost again and were told to pay for both. One year later they refused to revise the braces - for growth. Back in court again, - by the way her father is a sitting federal judge - these ass holes don't care. They lost again and again only paid one brace adjustment. Even when you win, they don't lose. Meanwhile two other children with the same disorder, also in that HMO, were getting the same refusals. Their families shared many things. Given transcripts of the court decisions in exactly similar cases, the HMO simply did not respond, even to registered letters. Group actions are not allowed. And penalties for repeated offences don't exist! There is no mechanism for relief of harassment by way of bureaucratic evasive behaviors. And liability for ill effects of policy is not provided for. Where in hell is Nuremberg? On the moon? What country is this?" "Wipe you mouth," Shannon whispered, making a subtle gesture with her hand. Mac fell into his chair, using his sleeve to tidy up. Shannon took over and summarized more cases. The last three were the most vile. A four year old double amputee, from a train mishap, was allowed only one prosthetic limb - forever. No argument satisfied. Two missing legs to share one prosthesis. No growth allowed. An Amerimed reviewer told a mother that if she persisted in pushing for coverage for her two year old daughter, who had post chicken pox encephalitis paralysis, that