THE BRONX, N.Y. (PIX11) – It’s been heartbreak after heartbreak for a Bronx family after a father, who was diagnosed with a rare cancer, has been denied by his insurance company three times for what they say is a lifesaving operation.
Despite the denials, they’re not losing hope — but they say time is running out for Anthony Di Laura.
“I’m sitting here and I’m suffering,” Di Laura told PIX11 News in an exclusive interview. “Every day is a battle.”
For two years, he has been fighting Pseudomyxoma Peritonei or PMP. The National Organization of Rare Diseases said two in every 1 million people are diagnosed.
Di Laura’s wife, Jackie Cucullo, has been fighting the tough journey alongside him.
“It originated as a tumor in the appendix and then spread to additional abdominal organs,” Cucullo said.
Mucin developed in Di Laura’s stomach, so he had major surgery to remove the stomach organs infected. Still, the cancer did not go away. Chemotherapy did not heal him either.
What makes the journey even more difficult is that Di Laura’s family said he has been approved for a lifesaving surgery by doctors at Cleveland Clinic in Ohio, but their insurance has denied the multi-organ transplant three times.
“How is this possible?” Di Laura questioned. “We were approved for all the testing at the clinic to lead up to the transplant.”
A denial letter from Empire Blue Cross Blue Shield said the surgery is “investigational.”
“[It says] that this has not been done many times,” Cucullo said. “They continue to ask for more documentation which I know has been provided.”
The Ohio surgeon, Dr. Anil Vaidya, completed the surgery on one other patient in that state and was successful. Di Laura’s family said the operation is their last hope after a different surgeon told them the mucin in his stomach is becoming cement-like.
They’re optimistic that they will get over this hurdle though because they’ve dealt with challenges before. Cucullo was told she’d never be able to get pregnant, but a few months after Di Laura’s diagnosis, the couple welcomed a baby boy.
“We just decided that this was God’s plan,” Cucullo said. “We had one miracle and that’s it. We’re totally happy and ready to move on.”
That was until the second miracle happened and Cucullo got pregnant again. Their baby girl is just two weeks old.
They believe their third miracle will pull through with approval for the surgery. In the meantime, they have each other to lean on.
“You don’t see this in this day and age, this type of love,” Di Laura cried. “I wouldn’t be here, I really wouldn’t, if it wasn’t for her taking care of me.”
Because Di Laura and Cucullo exhausted their three appeals with the insurance company, an independent external review with New York State is their next and final shot at getting approved. The family said Cleveland Clinic hospital is submitting the paperwork on Tuesday and an expedited decision is expected about five days later.
The family has raised over $100,000 on GoFundMe, but they say the operation could cost anywhere from $500,000 to $1 million without insurance.
PIX11 News reached out to the insurance company for comment.
“We recognize this is an incredibly difficult situation for Mr. Di Laura and his family, and we plan to continue to provide our support as we have done over the past several months,” an Empire Blue Cross Blue Shield spokesperson said. “We are working closely with Mr. Di Laura’s medical team and are conducting an external review to determine if this procedure could be proven to improve net health outcomes based on how the disease has progressed. We are also working with the Cleveland Clinic to understand what might be possible from a clinical trials perspective.”