Healthcare in Hawaii Determined by Marijuana Use1

Marijuana use may have cost Big Island woman a life-saving liver
transplant

By Chelsea Jensen
West Hawaii Today

Updated at 1:21 p.m., Saturday, August 8, 2009

Big Island resident Kimberly Reyes, who was diagnosed with Hepatitis in
March 2008, had been told in July that she had less than 30 days to
live. Her family claimed the Waimea resident had followed doctor's
orders, but her insurance carrier, Hawaii Medical Service Association,
denied her coverage for a liver transplant she needed to survive because
three toxicology tests showed trace amounts of cannabis in her system.

According to Reyes' attorney, Ted Herhold, with San Francisco-based
Townsend and Townsend, toxicology tests from June 14, July 3 and July 14
were the sole final basis for HMSA's final denial of coverage for the
51-year-old mother of five.

Reyes' mother, Noni Kuhns, and Kimberly's husband, Robin, acknowledged
HMSA's decision was based upon a failure to comply with the insurer's
policy forbidding drug use. However, both claimed after the claim denial
that neither HMSA nor her doctors notified Kimberly or the family of
HMSA's apparent policy on drug use.

Following at least five separate telephone inquiries from West Hawaii
Today made over a one-week period, HMSA public information officer Chuck
Marshall replied through an e-mail that HMSA declined to comment. HMSA
also declined to provide the insurance carrier's standard policies in
regard to drug use or drug use and transplant approval.

Kimberly Reyes died July 27 at Hilo Hospital, 16 months after being
diagnosed. In the months after her diagnosis, she suffered cirrhosis of
the liver, chronic Hepatitis infection, end-stage kidney disease and
hepatorenal syndrome, which is caused by low blood flow to the kidneys
due to liver deterioration.

"Just because someone takes a hit off of a joint doesn't mean that it
should be the end of their life -- this is not a reason to deny life,"
said Kuhns.

The Hepatitis virus attacks the liver and interferes with its function,
leading to liver failure and cirrhosis, or fatal scarring, of the liver,
according to the Mayo Clinic.

Kimberly Reyes was twice denied her application for transplant by HMSA
for "technical reasons," such as missing required Alcoholics Anonymous
meetings because she was too weak for doctor appointments, claimed
Kuhns. However, on July 17, Reyes received HMSA's approval for a liver
transplant.

That approval signaled that the Reyes family and HMSA had apparently
resolved compliance issues, Herhold said.

Three days later HMSA denied the transplant approval after it received
toxicology tests that showed cannabis in her system, Herhold said.

He claimed her marijuana use was "an indiscretion. "

She did not, according to her attorney and family, have a prescription
for medical marijuana use.

Kuhns and Robin both claimed Kimberly Reyes had stopped smoking
marijuana "years ago," but took a few hits off a marijuana cigarette
that day to relieve feelings of nausea, disorientation and pain.

Reyes, who was in Hilo Hospital's intensive care unit before her death,
on July 23 declined to speak with West Hawaii Today, saying she was
having difficulty talking, was worn out and not in the mood.

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