See-Saw Monday Winds Up With Reversal Of Fortune In Stafford Family's Race For Triple Transplant

STAFFORD, CT — What began as another level of frustration turned into a ray of hope Monday for a Stafford family facing the need for a complicated medical procedure.

Coverage for a transplant was again denied on appeal Monday for Justin Oswell, his wife, Renee said.

But hours later, a state official's review turned things around.

Renee Oswell said risk was cited in the original denial early Monday by insurance carriers. The family again cried foul play because the Cleveland Clinic says the triple transplant is not only necessary, but can be accomplished.

"We have to take that risk," Renee Oswell said.

A higher-level appeal was able to go through the state because Justin Oswell is a state employee via the Department of Corrections.

"It's about Anthem Blue Cross and Blue Shield's and Quantum Health's denial of coverage for a medically necessary transplant for a Stafford Springs resident," state Sen. Jeff Gordon said in taking up the Oswells' cause.

That was Monday morning.

By 4:01 p.m., Gordon, who is also a physician, announced that state comptroller Sean Scanlon approved an override.

Said Gordon, who insisted backing the family was not an election-year stunt, "I am incredibly grateful that Justin Oswell has now received approval for the life-saving transplant his doctors at the Cleveland Clinic determined he needs. This is wonderful news for Justin and his family, who have spent far too long fighting for the care that his doctors have said is medically necessary.

"I want to thank Comptroller Sean Scanlon for taking the time to speak with me about Justin's case, agreeing with me that an approval needed to be issued, and ultimately overriding the insurance denials and approving the care he needs. His willingness to step in has made a meaningful difference for Justin and his family."

Scanlon then called Renee Oswell personally.

"We're letting the clinical team know that he is all set for the transplant list and insurance will be approved," she said.

"No patient or family should have to endure such an extensive and exhausting process to receive lifesaving medical care," Gordon said."As a doctor, I have seen situations like this firsthand far too often, and I have spent years fighting against unnecessary insurance and case review barriers that delay or deny medically necessary care. We have taken important steps forward through my collaborative leadership in the Senate, but there is still more work to do. I will continue fighting so that fewer families are forced to go through what Justin's family has experienced."

In essence, Justin Oswell needs a three-way transplant to get completely healthy again. The procedures are part of a multivisceral transplant, meaning he will receive a liver, pancreas, and intestinal transplant all at once, and all of the organs must come from a single donor.

The community has been rallying via a GoFundMe campaign to offset some of the costs. As of Monday afternoon, more than $43,000 has been raised. To access the campaign, click here.