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Senator urges insurance committee review after being denied knee injection, says he paid $1,000
Summary
A longtime senator told the chamber he was denied a recommended knee injection by plan administrators and paid $1,000 out of pocket; he asked the lieutenant governor to appoint a committee to bring health-plan administrators before the Insurance Committee to explain coverage decisions.
During a point of personal privilege, a senior senator recounted difficulties obtaining coverage for a medically recommended knee injection and asked the lieutenant governor to convene the Insurance Committee to question the health-plan administrators.
The senator said his orthopedic surgeon diagnosed bone-on-bone degeneration and recommended an injection that would provide lubrication and mobility. “They refused me, so I had to pay 1000 dollars for an injection to go on my knee,” he said. He contrasted that out-of-pocket cost with the much larger expense of surgery, adding that a knee replacement would be far more costly if required.
The senator asked that the Insurance Committee bring the officials who manage the Senate’s health plan before the committee, saying the plan is “doing things and making decisions that I disagree with.” The Presiding Officer acknowledged the request and the senator was thanked for raising the issue; the record contains no immediate response from plan administrators.
What’s next: the senator asked the lieutenant governor to appoint a committee to examine the issue; the transcript records only the request and not any scheduled follow-up, so implementation remains to be determined.
(Reporting based on senators’ remarks in the Senate chamber.)
