Big Island resident Kimberly Reyes, who was diagnosed with Hepatitis in March 2008, had been told in July that she had less than 30 days to live. Her family claimed the Waimea resident had followed doctor’s orders, but her insurance carrier, Hawaii Medical Service Association, denied her coverage for a liver transplant she needed to survive because three toxicology tests showed trace amounts of cannabis in her system.
According to Reyes’ attorney, Ted Herhold, with San Francisco-based Townsend and Townsend, toxicology tests from June 14, July 3 and July 14 were the sole final basis for HMSA’s final denial of coverage for the 51-year-old mother of five.
Reyes’ mother, Noni Kuhns, and Kimberly’s husband, Robin, acknowledged HMSA’s decision was based upon a failure to comply with the insurer’s policy forbidding drug use. However, both claimed after the claim denial that neither HMSA nor her doctors notified Kimberly or the family of HMSA’s apparent policy on drug use.
Following at least five separate telephone inquiries from West Hawaii Today made over a one-week period, HMSA public information officer Chuck Marshall replied through an e-mail that HMSA declined to comment. HMSA also declined to provide the insurance carrier’s standard policies in regard to drug use or drug use and transplant approval.
Kimberly Reyes died July 27 at Hilo Hospital, 16 months after being diagnosed. In the months after her diagnosis, she suffered cirrhosis of the liver, chronic Hepatitis infection, end-stage kidney disease and hepatorenal syndrome, which is caused by low blood flow to the kidneys due to liver deterioration.
“Just because someone takes a hit off of a joint doesn’t mean that it should be the end of their life — this is not a reason to deny life,” said Kuhns.
The Hepatitis virus attacks the liver and interferes with its function, leading to liver failure and cirrhosis, or fatal scarring, of the liver, according to the Mayo Clinic.
Kimberly Reyes was twice denied her application for transplant by HMSA for “technical reasons,” such as missing required Alcoholics Anonymous meetings because she was too weak for doctor appointments, claimed Kuhns. However, on July 17, Reyes received HMSA’s approval for a liver transplant.
That approval signaled that the Reyes family and HMSA had apparently resolved compliance issues, Herhold said.
Three days later HMSA denied the transplant approval after it received toxicology tests that showed cannabis in her system, Herhold said.
He claimed her marijuana use was “an indiscretion.”
She did not, according to her attorney and family, have a prescription for medical marijuana use.
Kuhns and Robin both claimed Kimberly Reyes had stopped smoking marijuana “years ago,” but took a few hits off a marijuana cigarette that day to relieve feelings of nausea, disorientation and pain.
Reyes, who was in Hilo Hospital’s intensive care unit before her death, on July 23 declined to speak with West Hawaii Today, saying she was having difficulty talking, was worn out and not in the mood.
– Article from the Honolulu Advertiser on August 8, 2009.