Cleveland Clinic is working to get New York state to conduct an independent external review of a Bronx man's rare cancer diagnosis and recommended multi-organ transplant after Empire Blue Cross Blue Shield denied coverage, WPIX reported July 12.
Anthony Di Laura was diagnosed with pseudomyxoma peritonei two years ago, a rare cancer that only affects 2 in every 1 million people. The cancer began in his appendix and spread to other organs. He had surgery to remove his appendix, some areas of his stomach and chemotherapy, but to no avail.
Mr. Di Laura was approved for a multi-organ transplant surgery and the pre-testing services by physicians at Cleveland Clinic. The surgeon, Anil Vaidya, MD, was the first in the world to perform the surgery in September, with no evidence of cancer recurrence in the patient to date.
Empire BCBS has denied the surgery for Mr. Di Laura three times, citing it as "investigational."
Because three appeals are the maximum possible, the Clinic submitted paperwork July 12 to New York state to request an independent review of the situation. A decision is expected within about five days.
The cost of the surgery without coverage could range from $500,000 to $1 million, and the family has so far raised over $160,000 on GoFundMe.