Eunice Stallman, MD

Physician for State of Idaho via @OhioStateMed and @UWMedicine, proud mom of 5, occasional writer, and advocate for healthcare reform #StandUpForZoey

[Eunice Stallman, MD @EStallmanMD]

@bgazzar @CodeWack Hi! I will send you a message.

[Sophie Putka @SophNaama]

Blue Cross Idaho repeatedly denied doctor-recommended treatment for this baby girl's rare brain cancer - until her mother raised hell. @EStallmanMD @medpagetoday
https://t.co/Ez8CXeWzvX

[Eunice Stallman, MD @EStallmanMD]

ETA: this link should give access to full text— https://t.co/LrmsvmroxQ

[Eunice Stallman, MD @EStallmanMD]

Navigating my infant daughter’s diagnosis and treatment for brain cancer has been excruciatingly painful and eye-opening. Prior authorization denials and dealing with insurance made it so much worse. Writing about it has helped. https://t.co/9Zssgco3zo

[Eunice Stallman, MD @EStallmanMD]

@Dr_RShatsky @AnthemBCBS My infant daughter’s treatment for brain cancer was also repeatedly denied by
@BlueCrossIdaho
Pharmacist reviewers with no oncology experience last summer. The infectious disease pharmacist also did the “Peer”-to-peer. Finally reversed after significant escalation. So awful.

[Rebecca Shatsky, MD @Dr_RShatsky]

Spoke to the “peer” @AnthemBCBS provided today, who was a pharmacist with no speciality training in oncology. She refused to approved my request to start my patient at a lower dose. They said there is no oncologist I can talk to, which seems illegal. #reformpriorauth

[Eunice Stallman, MD @EStallmanMD]

@mattbc @WendyHassonMD I learned that my plan is NOT ERISA as a state employee. I assume this is good news. Our grievance process has been painful and not fruitful (basically denying they did any wrong). I may DM you, Matthew.

[Eunice Stallman, MD @EStallmanMD]

@DefectiveBecca @seattlechildren So sorry for your loss. Thinking about Eddie, and the rest of your family❤️

[Eunice Stallman, MD @EStallmanMD]

@vasisht @marklewismd Very little accountability in my experience. I filed complaints with the state medical boards of reviewers at Blue Cross (Idaho) and the third party reviewer with MCMC (Texas) who also supported denial. Texas board said not investigating bc not directly prescribing/harming pt.

[Eunice Stallman, MD @EStallmanMD]

@txsportsdoc @CarelonHealth @bluecrossidaho I have reported to

[Eunice Stallman, MD @EStallmanMD]

@txsportsdoc @CarelonHealth Same experience with our daughter with brain cancer. @bluecrossidaho used PharmDs as “peers” to deny treatment repeatedly, using the wrong NCCN guidelines. Then used a third party MCMC, were dr there also used wrong guidelines and evidence to rec denial. We need policy change.

[Robert Berry, DO @txsportsdoc]

Today BCBS wouldn’t approve surgery for acute ACL tear in young female athlete. They now are using a third party company called @CarelonHealth to decide if my patients board certified fellowship trained former NFL ortho surgeon recommended the correct care. This has to stop. Every medical org needs to address this and lawsuits need to be filed. Every legislator needs to work to pass laws banning prior Auths and peer to peers.

[Eunice Stallman, MD @EStallmanMD]

@DGlaucomflecken @bluecrossidaho Thanks for sharing our case. Infuriatingly, going through grievance with BCI and received our claim file- realized they denied 3x referencing ADULT @NCCN CNS cancer guidelines. The pediatric NCCN guidelines (supporting targeted tx) were not reviewed…Zoey is a baby. Not an adult.

[Wendy Hasson MD @WendyHassonMD]

1/Amazing news for those following #StandUpForZoey and @EStallmanMD’s journey. After @bluecrossidaho tried to deny cancer treatment, Zoey has been on treatment for 4w with PHENOMENAL results! Tumor shrunk significantly and Drs say her response is “more than anyone had hoped for”.

[Eunice Stallman, MD @EStallmanMD]

@shycollie Yes, we applied for this as soon as we got the first denial. Unfortunately Pfizer reviewed and required a long process called “Single patient IND” (takes min 1 month- need to go through FDA and IRB) to approve compassionate care Lorbrena for patients under 18. Dead end for us.

[Eunice Stallman, MD @EStallmanMD]

@KristinaMFiore @bluecrossidaho Hi Kristina, thanks. I just sent you a message.

[Eunice Stallman, MD @EStallmanMD]

Hi @bluecrossidaho. This is my daughter that you tried to deny care for. When a team of expert Drs recommend a treatment, your PharmD reviewers don’t get to deny her life-saving care for your profits. Your alternative rec: “Talk with your child’s Dr about other options”. What?!

[Wendy Hasson MD @WendyHassonMD]

1/Please share this thread on behalf of my physician colleague, Eunice Stallman, who is facing the nightmare of her 9mo daughter, Zoey, being diagnosed with brain cancer several weeks ago. @BlueCrossIdaho has added to their anguish by obstructing access to vital treatment.

[Eunice Stallman, MD @EStallmanMD]

@mattbc @WendyHassonMD @bluecrossidaho I will look into whether my plan is ERISA and get back to you. I had no idea either!

[Mark Lewis, MD, FASCO @marklewismd]

This is the classic (and morally reprehensible) playbook, @bluecrossidaho

1) deny
2) deflect
3) delay

And throughout, while you hide behind the pretense of financial stewardship, you are callously spending the precious currency the patient and their family truly lack: time

[Dr. Glaucomflecken @DGlaucomflecken]

Hey @bluecrossidaho do your job please. Immediately. Like right now.

[Eunice Stallman, MD @EStallmanMD]

You took away time and energy that we desperately needed to care for Zoey and our family. You took away time from my job taking care of my patients. How will you make this right @bluecrossidaho ? Many looking at you. #StandUpForZoey #StandUpForAll

[Wendy Hasson MD @WendyHassonMD]

10/ We must hold them accountable. Accountable to Zoey who deserves this medication for however long HER DOCTORS deem necessary. Accountable for every human in this country equally deserving as Zoey.  #StandUpForZoey #StandUpForAll