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CINCINNATI, Ohio — Margaret Fitzwater insisted she wasn't going to cry, but her eyes quickly turned red and watery as the 69-year-old grandmother of six described the impact of 189
CLEVELAND — Chuck and Angie Graham have been married 33 years.They have been through a lot together in that time, but perhaps their biggest challenge yet came in January.The Diagnosis"I woke up in the morning to go to work and I lost my balance a couple times and fell down," Chuck said.Angie said she heard something and yelled up to him if he was OK."He said he was falling and couldn't walk," Angie recalled, tearing up.An ambulance ride, and several tests and scans later, the Grahams had their answer — and it was devastating."She said that I had a very aggressive tumor in my brain and it was malignant," Chuck said.Such a diagnosis can make you feel so helpless, Angie said.The DenialThey say the next blow was just as unexpected.Their health insurance provider denied covering the procedure Chuck's neurosurgeon recommended to treat his cancerous brain tumor, saying it was "experimental" and "investigational."The laser ablation procedure was FDA-cleared a decade ago, but that does not guarantee coverage.The Grahams appealed the decision. Chuck was prepped for surgery hoping for a last-minute approval that never came, and he was sent home."Just the look on his face, broke my heart," Angie said."He's a veteran. He's a dad. He's a husband, a grandpa and a friend who would do anything for you. How could they not value him?"Fighting BackChuck's family took action.His daughter Jen Koons led the charge."They've just always been there for us," Jen said.And now she wanted to be there for them.Jen turned to the power of social media.She had previously sent the letter to the company before posting it to Facebook.It began: "An open letter to SummaCare and our health insurance industry..."Jen wrote about her father's fight with brain cancer and health insurance.The letter continued: "I hope thousands of people read this letter and understand that our physicians do not get to decide what's best for us, insurance companies do."Her post was shared nearly 3,000 times. Hundreds commented. Her message resonated.Fighting Back"I would say don't give up," Jen said.She learned about the right to an external review. It is a free service all health plan issuers must provide once the internal appeals process has been exhausted.An independent organization reviewed Chuck's case and overturned the denial.Two weeks after he had been sent home from the hospital, Chuck got the surgery his doctor had recommended."I just think we would've had a whole different scenario today if he hadn't had that surgery," Angie said.The external reviewer found Chuck's procedure "medically necessary" and "beneficial" for his condition."I just want people to understand their rights and to find their voice," Jen saidChuck's tumor is shrinking, and Jen is happy how things turned out for her dad, but angry, she says, for the people who don't have someone to advocate for them."There's how many people who go home and think, 'Oh, this is just the way it is,' " she said.In her open letter she wrote, "People deserve better. People deserve to count on their health insurance. They are more than a premium payment."Chuck's provider called the procedure "experimental and investigational." It was FDA-cleared a decade ago, but that does not guarantee coverage.There are not clear guidelines as to what defines "experimental and investigational."It can create a gray area where patients seeking innovative uses for a procedure are caught up."I'd like to see legislation around experimental procedures," said Tracy H. Porter of Cleveland State University.She said she'd like to see clarification and rules put in place, like with pre-existing conditions."I would also like to see something where we're educating patients more on their rights," Porter said.That is why Chuck and his family said they wanted to share their story; they want to help others navigate the often murky waters of a diagnosis and a denial.Jen has kept meticulous track of her father's paperwork. She has two bulky binders filled with research, correspondence with doctors, the hospital, insurance and notes from outside agencies.WEWS did reach out to SummaCare for this story.They provided us with this statement:"First and foremost, at SummaCare, we want what is best for our members in all cases. In accordance with federal privacy laws, we cannot discuss the specific medical care or associated claims of any of our members."ResourcesJen said she also found helpful resources through the 4465

CAPE CANAVERAL, Fla. (AP) — SpaceX has delivered two astronauts to the International Space Station. The Dragon capsule arrived at the station at about 10:16 a.m. Sunday, hours after a historic liftoff from Florida’s Cape Canaveral.NASA astronauts Doug Hurley and Bob Behnken reported Sunday that the capsule was performing beautifully, as they closed in for the docking. It's the first time that a privately built and owned spacecraft has delivered a crew to the orbiting lab. The capsule docked automatically, 19 hours after liftoff. SpaceX launched the Dragon from Kennedy Space Center on Saturday afternoon, the first astronaut launch from the U.S. to orbit in nearly a decade. 692
DENVER – Deputy U.S. Marshals say evidence shows an alleged child rapist faked his own death in Alabama and is now hiding out in Denver where his mother, brother and sister live.Jackson County Prosecutors in Pascagoula, Miss. charged Jacob Blair Scott, 42, with 14 sex charges alleging he raped a young girl. He disappeared on July 30, 2018, from Orange Beach, Ala. days before he was set to plead guilty in the case. Orange Beach is about 90 minutes from Pascagoula.Law enforcement found a dinghy floating in the ocean, a gun tied to the boat and what they describe as a suicide note listing contact information for Scott’s family.Deputy U.S. Marshal Katrina Crouse said investigators found the situation odd from the beginning. Only a very small amount of blood was found on the dinghy."Normally in situations where somebody is shot, committed suicide, you're going to have other forensic-type evidence. For example, brain matter, hair, skin, bone,” she said. “None of that was found."Investigators also found it odd that the gun was tied to the boat.“Almost like they wanted to make sure that the gun was discovered,” she said.No body was found and Crouse said it’s unusual, even in the ocean off shore, for a body to not be found. “Normally bodies will float to the surface,” Crouse said.Scott disappeared just days before he was set to plead guilty in court, she said.Scott’s mother, who lives in the Denver area, denied her son was alive when she was reached on the phone by Contact7 Investigates. She blamed the 14-year-old girl, saying the girl seduced her son.After Scott disappeared, a judge in Jackson County, Miss. issued an arrest warrant for Scott. He had been out on bond while his case moved through the legal system.He is now considered a fugitive.More questionsAs investigators looked into Scott’s disappearance, they discovered he withdrew about ,000 from his retirement account before vanishing.That strikes Deputy U.S. Marshal Crouse as odd.“If you take money out of an account, we know where that money goes. You either give it to relatives or you distribute it to friends,” she said. “No money has been located.”Sightings after the disappearanceA person who claimed to be a friend of Scott’s called the lead investigator in Jackson County, Miss. to say Scott had been spotted driving a vehicle in the county on Aug. 6, 2018.Investigators could not locate him.Then a tip came to the Mississippi Coast Crime Stoppers on Dec. 26, 2018.“The tipster stated that someone matching the description of Jacob Blair Scott was seen frequenting the Golden Spike Apartments,” Crouse said. The Golden Spike Apartments are located at West Yale Avenue and South Federal Boulevard in Denver.“The tipster stated the suspect was seen going up to the 8th floor and on the first floor,” she said.Deputy U.S. Marshals visited apartment management, who said they didn’t recognize Scott’s photo, but a worker at the apartments said he’d seen Scott smoking nearby.That’s the same story Mano Quintana told Contact7 Investigative Reporter Jace Larson at the apartment complex Wednesday.“He was in front of garbage cans smoking,” Quintana said.As he looked at Scott’s photo, he said he didn’t doubt he’d seen Scott on the property before.“Pretty darn sure. I’m really 100-percent positive it was him,” Quintana said.Reward for informationU.S. Marshals are hoping someone recognizes Scott and calls with information. 3424
COLLIER COUNTY, Fla. — Florida deputies say they have a cat burglar in custody. Literally, a cat. The burglar, named Bones, was found after Collier County Sheriff's deputies were called to a suspicious incident that was possibly a burglary in progress. 265
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