States help residents navigate denied insurance claims

When insurance companies refuse to pay for lifesaving medical treatment, many Americans give up, not realizing the law provides a powerful tool to challenge those decisions — the external appeal.

The Centers for Medicare & Medicaid Services (CMS) and consumer protection offices in Washington, D.C., Maryland, and Virginia confirm that thousands of patients remain unaware of their rights under federal and state law.

A ProPublica investigation detailed how one North Carolina couple, Teressa Sutton-Schulman and her husband, known in court filings as “L,” faced repeated denials from Highmark Blue Cross Blue Shield for psychiatric treatment that followed two suicide attempts in just 11 days. The insurer’s instructions for an external appeal were buried deep in the paperwork.

Once Sutton-Schu