Cody woman sues after health coverage denied
CODY — A Cody woman has filed a lawsuit against United Healthcare and numerous other parties for refusing to cover her prescribed life-saving radiology treatments.
According to United States District Court documents, Cody resident Erin Joyce was diagnosed with breast cancer following a routine mammogram on June 1, 2022. After she underwent a lumpectomy on January 18, 2023, Joyce’s physicians determined that she should receive post-surgical radiation, which “should follow breast surgery within eight weeks of the surgery,” the document said.
According to the document, Cody Regional Health and Joyce’s radiation oncologist, Bryce Lord MD, submitted a request for pre-approval of the radiation treatment “at or around the time of [her] surgery. However, UHC did not respond to the request until February 3 when it requested additional information before ultimately issuing a denial letter on February 8.
The letter said that Joyce’s prescribed therapy was “not medically necessary.”
Joyce’s court filing quoted the letter from UHC, which said its denial was “a benefit decision, not a medical determination. Only you and your doctor can decide what medical care you need.”
In her filing, Joyce said the letter from UHC completely disregarded “the fact the requested treatment was exactly the medical care Ms. Joyce and Dr. Lord “decide[d] [she needed].”
Joyce and Lord appealed the decision and submitted multiple documents supporting their claim.
After another month of back-and-forth between UHC and Joyce and her medical team, Joyce was once again denied coverage for her radiation therapy.
At this point, Joyce’s oncologist advised her that “delay in commencing the radiation treatments was dangerous,” the document said.
Therefore, Joyce elected to begin radiation treatments and pay for them out of pocket. She received 16 treatments between March 2 and March 23, 2023.
Joyce is seeking the sum of the medical benefits that she asserts were due to her under her health plan, totalling $15,472.
This story was published on February 24, 2025.