Former Aetna Medical Director Admits To Never Reviewing Medical Records Before Denying Care

| Educate!

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Is this the exception or the rule?

In an eye-opening exclusive reported by CNN, it was revealed that former Aetna Medical Director, Dr. Jay Ken Iinuma, admitted under oath that “he never looked at patients’ records when deciding whether to approve or deny care.”

This admission was made during a deposition in a lawsuit brought against Aetna by Gillen Washington, a 23 year old with common variable immune deficiency (CVID) who was denied coverage for an infusion of intravenous immunoglobulin (IVIG) four years ago.

California’s insurance commissioner, Dave Jones, is now looking into Aetna’s relevant protocols.

In his deposition, Iinuma, as reported by CNN, “said he was following Aetna’s training, in which nurses reviewed records and made recommendations to him.”

In this particular case, Iinuma admitted that he had minimal if any knowledge of the medical condition, common variable immune deficiency (CVID), that Washington suffered from. He was also not clear about what the most effective drug would be to treat the patients’s condition, the symptoms of CVID, or even the consequences of the abrupt discontinuation of therapy for the condition.

“Do I know what happens?” Iinuma said. “Again, I’m not sure…I don’t treat it,” according to the deposition, as reported by CNN.

Further, when asked by Washington’s attorney if it was his general practice to look at medical records as part of his decision making process, he replied that it was not.

This opens up the obvious question of just how transparent health insurers are being with the public regarding their process for approval or denialof coverage, especially for complex medical care and procedures.

Aren’t we to expect that an experienced and knowledgeable physician review a person’s medical records before approving or denying a potentially disease-modifying therapy or treatment?

In Aetna’s response to CNN’s inquiry, the company said “we…look forward to explaining our clinical review process.”

And we, the public, certainly look forward to learning more about it.

  • mwildfire

    No. Let’s just toss the parasites out of US healthcare and let doctors decide what treatment their patients need. (Yes, this guy apparently had an MD but he wasn’t using it in decision-making so he effectively was not a doctor).

  • Marjorie Trifon

    This is just MORE PROOF the US must move fwd w/MEDICARE FOR ALL. Poison, deny the paper-pushing parasites that jack up the cost of healthcare.

    OAT, I would add to the bill proposed by Jayapal, that NUTRITION must B taught in schools, churcfhes, and other societal institutions.

    The AMA–MORE PARASITES–MUST TEACH nutrition. eVERY TIME i SEE MY GP, i AM EDUCATING HER MORE AND MORE ON how much I have learned for myself about “alternative” methods of healing: acupuncture, chiropractic, hypnosis, all kinds of
    “energy work I have used for 50 years to heal . The AMA has a chokehold on what it will allow to B taught in medical schools–to the detriment of the sheeple.

    I had to learn & use al,l these alternative methods of “medicine” because I got all the “side effects” of almost every pharmaceutical. Big Pharma & Big Medicine are what is mkilling people–then they bankrupt folks.

    Dr. Carolyn Dean, MD, ND , author of The Magnesium Miracle, points out, for example, that US soils have been depoleted by Big Ag; therefore, most people are MAGNESIUM DEFICIENT.

    E.G, I suffered horribly from depression for decades. Now I make sure to add various forms of Mg to my daily diet. EUREKA! nO MORE DEPRESSION! i AM 84 YRS OLD AND i REGULARLY TAKE no prescription drugs. ZERO.

  • chetdude

    HR1384 – National Improved Medicare for All will eliminate creatures like this from the picture.

  • chetdude

    I’d also suggest that we should reform the training that medical professionals get.

    After passing HR1384 we can transition from a system of “medical education” designed and run by the AMA (rich doctor’s ‘union’) and Big PhRMA that emphasizes drugs and surgery and change it to a system of education that promotes Health instead while reserving drugs and surgery as last resorts instead of highly profitable defaults.