A Troubleshooters investigation has led the State to demand answers from a major insurance company, after a seven-month-old infant was not given the supplies he requires to sustain his life.
Seven-month-old Nolan Thomas Green was born with special needs. “He doesn’t breath through his mouth or his nose,” said his dad, Tom Green. Instead, he breathes through a trach tube inserted into his airway. When Nolan was born, doctors broke the heart-wrenching news to his mom and dad: Nolan suffers from brain damage because of a loss of oxygen to his brain. He has seizures and can’t breathe or eat on his own.
“That was pretty heartbreaking, but you know, he was our son and whatever we were up against, he was going to be who he is to us and that was what was important to us,” said Nolan’s mom, Toni.
Tom and Toni have transformed their Bethany home to accommodate little Nolan’s medical needs. They knew caring for their son was going to be a battle. But the Greens never imagined that their biggest fight would come from some of the very people who had promised to help.
“The trachs are basically his lifeline. It’s his airway and they rotate weekly. I sterilize them, but if a trach was to break down or malfunction, that’s the only way he can get air so it’s probably the most important piece of equipment that he has,” said Tom.
Medical supply company Genox Homecare signed on to supply those life-saving trach tubes Nolan needs. The company came recommended by Connecticut Children’s Medical Center, where Nolan spent the first 11 weeks of his life.
Tom is a state worker, and insurance company United Healthcare Oxford covers much of the cost for Nolan’s care and equipment. Everything was all set to go, or so the Greens believed. “The first delivery, two days before he came home, was incomplete and it’s been the same ever since. And he’s still never received any trachs whatsoever,” said Tom.
That was two months ago. The Greens said Genox never delivered the items they promised, even after the family’s repeated calls pleading with the company.
“His supplies in general are just dwindling and we’ve been stretching them as far as we can,” said Tom, “The last final option would be to go to the emergency room and have him admitted so that the hospital could provide trachs for him.”
“He has spent more than half of his life in the hospital so far. So, we’d like to keep him home as much as we can,” added Toni.
Tom told us the insurance company wasn’t helping. UnitedHealthcare Oxford would only give the family a list of other in-network supply companies to call, all of whom the Greens found out did not carry the pediatric equipment they needed.
They were desperate. They were running out of time. So they called the Troubleshooters.
No one from Genox Homecare or its parent company, Landauer Metropolitan, would return our phone calls. And just days after the Troubleshooters started asking for answers, Landauer Metropolitan filed for Chapter 11 bankruptcy.
The filings in federal court spell it out. The company owes thousands of creditors up to $100 million. And the chances the Greens would ever see those supplies seemed to get slimmer.
But the Troubleshooters kept digging--and now the State has agreed to investigate the Green’s situation.
Because, as it turns out, the insurance company is obligated by state law to stand behind their network providers. That means the company has to make sure the Greens get their supplies one way or another.
“From the information you gave me, one of the vendors looks to have not been able to deliver what they were required to send. And we want to make sure the insurance company is aware of this and that they have backups within their network to deliver the products the baby needs,” said Gerard O’Sullivan with the State Department of Insurance.
The Greens never knew that, and they claim the insurance company didn’t offer much help. In fact, they said they were doing everything on their own, including reaching out on Facebook, to find a medical supply company when the ones suggested by Oxford didn’t pan out.
“I mean I have strangers offering to send us supplies,” said Toni, “It’s amazing how wonderful people are out there who want to help and give us advice.”
The Troubleshooters reached out to Oxford. The insurance company promised us a solution was coming for the family, but would not answer any of our questions about why it’s taken months to get the Greens the life-sustaining supplies they’ve been begging for.
In a short statement UnitedHealthcare tells us, “We empathize with the Green family’s frustration and their case manager has arranged the delivery of the supplies that they need. The Greens will continue to receive the in-home nursing services that their plan provides.”
As for that bankrupt supplier? On Wednesday, Toni send us a picture of a special delivery—Genox Homecare finally delivered two custom trachs for Nolan.
And even though Oxford wouldn’t answer all of our questions, the State Department of Insurance said it’ll get to the bottom of why the Greens were forced to wait two months to get what Nolan needs. Department officials want consumers to know they’re here to help with any insurance-related issues, and only wish they’d known about the Green’s situation sooner.
“We need someone reliable for maybe a lifetime. At least years to come,” said Tom, “So my hope for him is that we find a company that can help us with this.”
In a statement, Connecticut Children’s Medical Center said hospital workers have advocated on the Green’s behalf: “Nolan Green has been our patient since April. Connecticut Children’s has worked closely with the Green’s to ensure that Nolan receives the quality of both hospital and post-discharge care that he requires.
Unfortunately, the family has had great difficulty procuring the critical supplies necessary for his care because of the lack of cooperation of the vendors. Our doctors and staff have advocated on their behalf and understand their frustration. The Greens need the support and assistance of not only the medical team, but also the vendors and insurers who provide necessary resources to allow them to care for their baby. We will continue to advocate on their behalf and urge the vendors and insurers to resolve this issue as soon as possible. “
If you need help with an insurance issue, the Department of Insurance consumer line is 1-800-203-3447. You can also contact them through the Department’s website.
And to follow Nolan’s progress on Facebook.