Health Insurance Denials, Prior Authorization Delays, and Patient Struggles: The Tennant Family’s Battle with Cancer Care Access

Tags: health insurance denial, prior authorization, cancer treatment delays, patient advocacy, medical necessity, histotripsy, healthcare policy reform, insurance appeals process, West Virginia healthcare, UnitedHealthcare, Medicare Advantage, ACA impact, medical fraud prevention, access to care

A Life on Hold: Cancer Diagnosis Meets Bureaucratic Resistance

In 2023, Eric Tennant of Bridgeport, West Virginia, was diagnosed with advanced bile duct cancer that had already metastasized to his bones. Weighing just 97 pounds, doctors gave him a bleak prognosis. However, after two years of aggressive chemotherapy, his condition stabilized enough to consider a new hope: histotripsy, a noninvasive liver tumor treatment that could potentially give him more time—and quality of life.

But a new battle began: his health insurer refused to cover the procedure, labeling it “not medically necessary.”

“Not Medically Necessary”: The Barrier to Critical Care

Although Tennant’s oncologist approved the procedure, his insurer—West Virginia’s Public Employees Insurance Agency (PEIA)—denied the claim. The family appealed four times. Each attempt was rejected, citing lack of sufficient evidence and classifying the treatment as “experimental.”

This experience reflects a widespread problem across the U.S. healthcare system, where millions of prior authorization denials each year block patient access to needed treatments, even when medically recommended.

A System Built for Denial?

Prior authorization is designed to control healthcare costs, reduce fraud, and protect patients. But critics argue it often delays or denies legitimate care, especially for those with life-threatening conditions. In many cases, patients are left fighting an appeals system that is complex, opaque, and unaccountable.

Dr. Jay Pickern, a health services professor, notes that insurers operate as profit-driven businesses: “At the end of the day, they’re not in the business of getting people better. They’re in the business of saving money.”

The Tennants’ Emotional and Financial Toll

As Eric’s health declined, his wife Rebecca described the appeals process as “a big mess,” marked by endless paperwork, phone calls, and frustration. She felt abandoned by a system that should have been helping them, not hindering them:

“They’re like, not accountable to anyone.”

After relentless pressure—and inquiries from news organizations—PEIA reversed its decision, calling it “a rare and exceptional situation.” But by that point, Eric was too sick for histotripsy. The months lost to administrative delays may have cost him his chance at treatment.

Growing Public Pressure, Limited Policy Reform

While isolated reversals like Tennant’s happen, systemic change remains elusive. Some states like Virginia and North Carolina have passed new laws to speed up authorization timelines or require specialists to review appeals. At the federal level, upcoming rules aim to streamline prior authorization for Medicaid and Medicare Advantage patients—but employer-sponsored plans remain largely unaffected, leaving out nearly half of insured Americans.

A System That Isn’t Designed for the Sick

As prior authorization becomes more widespread, critics say it’s being weaponized to withhold care, pad insurer profits, and undermine doctor-patient trust.

Rebecca Tennant, looking back on her husband’s ordeal, summed up the emotional toll:

“Time is precious. They know he has stage 4 cancer, and it’s almost like they don’t care if he lives or dies.”

Hope vs. Delay

Though Eric Tennant is no longer considered a viable candidate for histotripsy due to recent health setbacks, his family still hopes his condition might improve enough to revisit the option. Meanwhile, scans scheduled for July will determine the cancer’s progression, offering either a slim second chance—or another round of hard decisions in a system that too often leaves the sick with little recourse.