THE BRONX, N.Y. (WPIX) — A New York family has been repeatedly disappointed because the father, who has been diagnosed with a rare form of cancer, was denied by his insurance company three times for what they say is a lifesaving operation.
Despite the denials, they’re not losing hope — but they say time is running out for Anthony Di Laura.
“I’m sitting here and I’m suffering,” Di Laura told Nexstar’s WPIX in an exclusive interview. “Every day is a battle.”
For two years, he has been fighting Pseudomyxoma Peritonei, or PMP. The National Organization of Rare Diseases said two in every 1 million people are diagnosed.
Di Laura’s wife, Jackie Cucullo, has been fighting alongside him.
“It originated as a tumor in the appendix and then spread to additional abdominal organs,” Cucullo said.
Mucinous carcinoma developed in Di Laura’s stomach, so he had major surgery to remove the affected organs. Still, the cancer did not go away. Chemotherapy did not heal him, either.
Di Laura’s family said he has been approved for a lifesaving surgery by doctors at Cleveland Clinic in Ohio, yet their insurance has denied the multi-organ transplant three times.
“How is this possible?” Di Laura questioned. “We were approved for all the testing at the clinic to lead up to the transplant.”
A denial letter from Empire Blue Cross Blue Shield said the surgery is “investigational.”
“[It says] that this has not been done many times,” Cucullo said. “They continue to ask for more documentation, which I know has been provided.”
The Ohio surgeon, Dr. Anil Vaidya, successfully completed the surgery on one other patient in that state. Di Laura’s family said the operation is their last hope after a different surgeon told them the affected area in his stomach is becoming cement-like.
They’re optimistic that they will get over this hurdle, though, because they’ve dealt with challenges before. Cucullo was told she’d never be able to get pregnant, but a few months after Di Laura’s diagnosis, the couple welcomed a baby boy.
“We just decided that this was God’s plan,” Cucullo said. “We had one miracle, and that’s it. We’re totally happy and ready to move on.”
That was until the second miracle happened and Cucullo got pregnant again. Their baby girl is just 2 weeks old.
They believe their third miracle will be receiving approval for the surgery. In the meantime, they are leaning on each other.
“You don’t see this in this day and age, this type of love,” Di Laura cried. “I wouldn’t be here, I really wouldn’t, if it wasn’t for her taking care of me.”
Because Di Laura and Cucullo exhausted their three appeals with the insurance company, an independent external review with New York State is their next and final shot at getting approved. The family said Cleveland Clinic hospital was submitting the paperwork Tuesday and an expedited decision was expected about five days later.
The family has raised more than $100,000 on GoFundMe, but they say the operation could cost anywhere from $500,000 to $1 million without insurance.
WPIX reached out to the insurance company for comment but had not received a statement at the time this story was published.