Judge Backs Hopi Woman Against Uncle Sam

     PHOENIX (CN) – A Hopi woman with a rare blood disease may pursue claims that government delays cost her nearly $400,000 and left her without life-saving medication she received only after President Obama stepped in to help.
     U.S. District Judge David Campbell on Jan. 20 denied the federal government’s request for summary judgment in Cecilia Shortman’s lawsuit alleging negligence, breach of trust and unjust enrichment.
     Shortman sued Indian Health Services (IHS) and others in 2013, claiming officials needlessly delayed her eligibility review process and left her for months without medication that she needs to live.
     Without insurance, the medication to treat her congenital blood disease costs $128,880 per month, Shortman says.
     Without the agency’s final approval, her employer and Walgreens had to advance Shortman the cost of the medication for three months, leaving her $386,640 in debt.
     Shortman says that IHS processed her claim only after she contacted the Obama administration and told staffers about her plight.
     “That same day, IHS completed the eligibility review process and determined that Cecilia was in fact eligible for the medicine that she needed to keep her rare blood disorder in check,” Shortman’s complaint states.
     In its motion to dismiss, the government claimed, among other things, that Shortman “is not entitled to coverage for her medication costs under the applicable regulations because she missed appointments and otherwise failed to procure advance approval,” according to Campbell’s ruling.
     The government also claimed that Arizona’s negligent-delay law does not address “conduct analogous to defendants’ actions in this case,” and that the court lacks jurisdiction under the Federal Tort Claims Act.
     But Campbell ruled that summary judgment would be premature at this stage, and found “IHS’s relationship with plaintiff to be arguably analogous to that of an insurance company.”
     “IHS appears to have had the financial ability to cover the cost of plaintiff’s medications and, given the life-saving necessity of those medications, perhaps the legal obligation to cover them,” Campbell wrote.

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