The last person you’d expect to have battle with the health care system over a denial of benefits is a physician who has devoted most of his life to treating low-income patients.
But that’s precisely what’s happening to Dr. Curtis Speed, 70.
Speed, a pediatrician, treated patients for nearly 40 years, 15 of those years working at Cook County-operated Stroger Hospital.
“My husband is one of those people who worked his way up from a shoeshine boy in Arkansas all the way up to a pediatrician in Chicago,” says Edwina Leak Speed, his wife. “He worked in Roseland and Englewood and in some of the poorest neighborhoods.”
The couple had been married for just six years when, on the day after undergoing cervical neck surgery in March 2015, Speed suffered two cardiac arrests and was left without oxygen for 19 minutes.
“He was ‘code blue,’ ” his wife says. “There’s only a 5 percent chance that you can be without oxygen for that length of time and live.”
Dr. Speed suffered permanent brain damage and has been in a coma since.
His wife says she tried four nursing homes — where she says the care her husband got left him with bruises and bedsores — before she brought him home in July 2015.
His health benefits are covered by Cook County’s self-funded health plan, for which Blue Cross and Blue Shield of Illinois is the claims administrator. It initially approved the wife’s request for 24-hour, skilled, private-duty nursing care.
“His condition is so acute medically that [nurses] have had to go in there and pull his trach out of his neck,” Speed says.“The nurses have saved his life so many times.”
Then, in 2016, Blue Cross Blue Shield denied her request to reauthorize 24/7 private-duty nursing as of January 2017.
Speed appealed, and an independent reviewer sided with her. But a subsequent request for reauthorization was denied. According to the claims administrator’s medical director, the “requested services met the definition of Custodial, Respite, Long Term and Maintenance Care Services, which are not covered under Dr. Speed’s health plan.
Speed again appealed, but the independent reviewer chosen by Blue Cross Blue Shield upheld the denial of benefits.
The wife was devastated.
“Their stance is that my husband’s care does not require a nurse, and they are deeming him [to be] in ‘custodial care,’ which means me or my niece or anyone off the street can make the same lifesaving decisions that the nurses make,” Speed says. “That’s absolutely ridiculous.”
She turned to Cook County Board President Toni Preckwinkle.
“I called Preckwinkle and begged her not to do this” Speed says. “She sent me a letter and put if off on Blue Cross Blue Shield.”
On Feb. 14, 2018, the wife sued, but a Cook County judge found that the county does not have an obligation to continue to provide 24/7 nursing care for Dr. Speed in his home and gave Speed until Oct. 6 to make other arrangements.
“The evidence showed that nursing home ventilator units are available and are staffed to meet the needs of patients like Dr. Speed,” Judge Pamela McLean Meyerson wrote in an order denying a request for a preliminary injunction.
Frank Shuftan, a spokesman for Preckwinkle, defends the denial of the 24/7 nursing benefit.
“The circuit court recognized that the 24/7 private-duty nursing care which Dr. Speed is receiving is not a covered benefit,” according to Shuftan. “No elected official has the authority to unilaterally overturn the decision of the court.”
Speed has not given up trying to get what she considers life-saving treatment for her husband. Nor should she. In another case, in 2011, the federal government and the state of Illinois sued Blue Cross Blue Shield, saying the insurer wrongly influenced the review process over the denial of care for a young woman in the northwest suburbs. The insurer settled for $25 million.
Dr. Speed and his wife still are covered by Cook County’s health plan and pay a $500 monthly premium. The doctor’s care costs an estimated $500,000 a year.
“The insurance company is just tired of paying,” Speed says.
Independence Plus, Inc., the agency that has provided private-duty nurses for Dr. Speed, is willing to provide 24/7 care for him for approximately two months beyond the Oct. 6 cutoff date, at its own expense, to keep Dr. Speed at home while Cook County reconsiders.
“Dr. Speed is simply not a candidate for a long-term facility,” says Tamara M. Muller, founder and chairman of the company. “He requires either an ICU setting or one-on-one skilled home nursing, as he has been receiving since July 2015.”
Speed set up a Go Fund Me campaign and is asking for the public’s support.
This tragic situation shows why we should be concerned about where this country is headed.
If this could happen to a physician, God help the rest of us.
To donate, go to: www.gofundme.com/medical-rescue-for-dr-curtis-speed