In Recusal, Judge Calls Insurer's Decision 'Barbaric'

UnitedHealthcare wouldn't pay for proton beam therapy
By Bob Cronin,  Newser Staff
Posted May 16, 2019 5:15 PM CDT
Suit Against Insurer Goes to Judge With the Same Complaint
The UnitedHealth Group Inc.'s campus in Minnesota. The insurer faces a class-action suit over denial of a treatment for prostate cancer.   (AP Photo/Jim Mone, File)

A class-action lawsuit against an insurer for denying cancer patients coverage of an alternative to standard radiation treatment happened to come before a judge with the same complaint—against the same company. The federal judge recused himself, CNN reports, but not before giving UnitedHealthcare an earful, calling the insurer's denials "immoral and barbaric." The treatment is a more expensive alternative to standard radiation called proton beam therapy, which proponents say is more precise and has fewer side effects. Others argue proton beam therapy isn't worth the higher cost, and insurers have called it "experimental" in refusing to pay for it. "It is undisputed among legitimate medical experts that proton radiation therapy is not experimental and causes much less collateral damage than traditional radiation," Judge Robert Scola wrote.

After consulting prostate cancer experts around the country, Scola paid for the $85,000 treatment himself while appealing the insurer's rejection. A friend did the same thing, paying $150,000; UnitedHealthcare reimbursed him after being threatened with a lawsuit. Scola wrote that the two cases kept him "from deciding this case fairly and impartially," per The issue isn't clear-cut, some experts say. "The judge is wrong. He does not know the facts, and he has fallen for some of the advertising," said Dr. Otis Brawley, a professor of oncology at Johns Hopkins and a former chief medical officer at the American Cancer Society. While the physics of proton beam therapy might suggest fewer side effects, Brawley said, "There is currently no evidence that proton beam radiation therapy offers any advantages." (More prostate cancer stories.)

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