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When he was diagnosed with two autoimmune diseases, Joel Hechler knew he’d be in for a battle. He didn’t realize maybe his toughest one would be with his insurance company.“I think they put the dollars ahead of a patient’s health,” Hechler said. “I don’t think they fully understand the impact the medicine will have on my long-term health and well-being."Hechler suffers from Crohn’s disease and ulcerative colitis, diseases that attack the lining of his digestive tract. Autoimmune conditions like his can’t be cured but, with the right medication, the symptoms can be controlled.  Finding the right medicine can be hard for those suffering from autoimmune diseases. Even if there are scores of drugs on the market, some patients might only respond to one. In Joel’s case, his doctor thought he’d have a better chance trying a drug called Remicade.“I received a letter from my insurance company that denied the Remicade on the basis that I have to try a different drug before I can get to Remicade," Hechler said.Hechler's insurance company, Premera Blue Cross, wouldn’t approve the drug his doctor prescribed because they wanted him to try a cheaper one first.It’s part of a program that health insurers nationwide use called step therapy, requiring that patients try less-costly drugs before “stepping up” to more expensive ones — even if doctors believes the cheaper drug won’t work.Dr. Larry Adler is president of Huron Gastro in Ypsilanti, Michigan and says he spends virtually every day battling insurance companies over step therapy drugs.“They have to fail this medicine first before they get the new drug,” Adler said. “That doesn’t make any sense.”Adler says it's common for patients to get sicker while waiting for step therapy to run its course.In Hechler's case, it took six weeks of fighting with his insurer to convince them that the cheaper drug wouldn’t be effective. As he was waiting, he was getting worse.“It got to the point where I had to be admitted to the hospital,” Hechler said. "I was very, very sick.”Step therapies are used by insurers to try to control skyrocketing prescription medicine costs, says Glen Perry, Director of Pharmacy Contracting and Sales for Blue Cross Blue Shield of Michigan.“These drugs can cost up to 0,000 per year. These are not cheap medications,” Perry said.“It seems like you’re telling patients that, in many cases, your insurer knows what’s best for you, rather than your doctor,” Jones said.“We are trying to provide the most cost effective and safe medication use,” Perry said, adding that when a doctor and insurer disagree over a drug, they can usually resolve the case within a few days without putting a patient at serious risk.“A delay of one or two days I don’t think is really going to make that much of a difference for the medical outcome of the patient," he said.But for many patients, like Phyllis Toole, the delay is longer than a few days.Phyllis suffers from rheumatoid arthritis, a condition where her body attacks her joints. When her doctor wanted to put her on Orencia, her insurance company HAP said she needed to first try a less expensive drug, Humira.But Phyllis’ doctor was worried about possible side effects and thought Humira could be risky.After battling for months, Phyllis says the whole thing made her feel more like a number than a patient. With her doctor and insurer in a standoff, she was forced to rely on samples of the drug she got from her doctor. HAP never approved her prescription.“They’re playing doctor, is what it feels like,” Toole said. “They’re saying this is what you can have for the symptoms you have. It may make you sicker, but this is what you can have.”HAP issued the following statement to Scripps station WXYZ in Detroit: 3800

When the Trump administration first asked the Pentagon to send troops to the southern border, they wanted them to perform emergency law enforcement functions, CNN has learned.The Pentagon said no.According to two defense official familiar with the request, the Department of Homeland Security asked that the Pentagon provide a reserve force that could be called upon to provide "crowd and traffic control" and safeguard Customs and Border Protection personnel at the border to counter a group of Central American migrants walking to the U.S. border to request asylum.The Pentagon rejected the request on October 26, according to one of the officials, even as it signed off on providing DHS with air and logistics support, medical personnel and engineers.The request was turned down because the Department of Defense felt that active duty troops do not have the authority to conduct that type of mission unless they are granted additional authorities by the President.Defense officials have repeatedly emphasized the troops at the border are there to support civil authorities and that they are not expected to come into any contact with migrants. 1154

What began with a quick grab-and-go theft Saturday at the San Antonio Aquarium -- the suspect leaving a trail of water drops as he hurried away with his dripping prize of a small but very much alive shark -- ended Monday with the safe return of "Miss Helen" to her tank at the aquarium.The 16-inch female horn shark was taken during a heist that aquarium officials said was no spur-of-the-moment, let's-steal-a-shark thing."The suspects staked out the pool for more than an hour" to wait for the right moment, the aquarium said in a statement.The search for the young female shark, known to aquarium staff as Miss Helen, led police Monday to the home of a man who maintains an extensive collection of marine life, according to the police chief of the San Antonio suburb where the aquarium is located. 808

White House officials were alarmed by Education Secretary Betsy DeVos' struggle to answer basic questions about the nation's schools and failure to defend the administration's newly proposed school safety measures during a tour of television interviews Sunday and Monday, according to two sources familiar with their reaction.Though DeVos was sworn in to her Cabinet position 13 months ago, she stumbled her way through a pointed "60 Minutes" interview with CBS' Lesley Stahl Sunday night and was unable to defend her belief that public schools can perform better when funding is diverted to the expansion of public charter schools and private school vouchers. At one point, she admitted she hasn't "intentionally" visited underperforming schools."I hesitate to talk about all schools in general because schools are made up of individual students attending them," DeVos said, as Stahl suggested that DeVos visit those underperforming schools.Things worsened as DeVos continued her cable television tour Monday morning. The White House released its proposals for school safety measures after a shooting in Florida killed 17 people. Part of the proposal includes a task force to examine ways to prevent future mass shootings, headed by DeVos. Though the proposals don't include raising the age limit to purchase firearms from 18 to 21 -- as President Donald Trump once suggested -- DeVos told Savannah Guthrie on NBC's "Today" show that "everything is on the table.""The plan is a first step in a more lengthy process," DeVos said, adding that she does not think that arming teachers with assault weapons would be "an appropriate thing.""I don't think assault weapons carried in schools carried by any school personnel is the appropriate thing," DeVos said. "But again, I think this is an issue that is best decided at the local level by communities and by states.""The point is that schools should have this tool if they choose to use the tool. Communities should have the tools, states should have the tool, but nobody should be mandated to do it," she said.The White House did not respond to a request for an official comment regarding DeVos' performance. It is unclear what Trump's own reaction to her interviews was, but officials in the West Wing said things went from bad to worse as DeVos continued her interviews.DeVos is just the latest member of Trump's Cabinet to come under scrutiny. Interior Secretary Ryan Zinke, Housing and Urban Development Secretary Ben Carson, Veterans Affairs Secretary David Shulkin and Environmental Protection Agency Administrator Scott Pruitt were all scolded by officials from the White House counsel's office and the Cabinet liaison after a series of embarrassing and questionable ethical behavior at their respective agencies.This isn't the first time DeVos has made headlines. She also struggled to answer education questions during her contentious confirmation hearing before the Senate last January. At one point, she told Democrat Sen. Chris Murphy that some schools may require guns to fight off grizzly bears."I will refer back to Sen. (Mike) Enzi and the school he was talking about in Wyoming. I think probably there, I would imagine that there is probably a gun in the schools to protect from potential grizzlies," she had said.In the end, Vice President Mike Pence had to break the tie to confirm her nomination, making her the first Cabinet nominee in history to require a tie-breaking vote by the vice president to be confirmed. 3545

With a crowd of onlookers gathered around, New York Police officers encircle a woman and her child on the ground.One officer reaches down and begins to pull. The officer yanks harder, and harder, and the woman's cries become louder."You're hurting my son! You're hurting my son!" she yells.A tug of war ensues, and as noise from the horrified crowd builds, an officer brandishes a yellow stun gun and begins to point it around the room, a government welfare office in Brooklyn.The stunning and hectic scene, captured on video and posted to Facebook, ends with the woman in handcuffs escorted from the scene — and her 1-year-old son elsewhere. A family member took custody of the child following the arrest, the NYPD said.The forceful arrest of the unarmed mother at a social services office has caused a significant backlash, particularly from those who saw it as an unnecessarily violent escalation and a symbol of how the poor are treated in America."Being poor is not a crime. The actions of the NYPD in this video are appalling and contemptible," said Letitia James, the Public Advocate for New York City.Facing criticism, the NYPD and the New York City Human Resources Administration are now reviewing that December 7 arrest."Video images of the incident in the 84th precinct are troubling," the NYPD said in a statement, adding that the review will "include examination of all available video of the incident."Corey Johnson, the speaker of the New York City Council, said it was "unacceptable, appalling and heart breaking.""I'd like to understand what transpired and how these officers or the NYPD justifies this. It's hard to watch this video," he said on Twitter.On Facebook, James called for a full investigation into the officers' conduct and said the results should be made public. She also called for the officers involved, including their assigned supervisor, to be assigned to desk duty until an investigation is complete."No mother should have to experience the trauma and humiliation we all witnessed in this video," she said. 2056