Baby Cam gets approval for critical brain surgery

BUFFALO, N.Y. — We have an update to the baby Cam story. 

Cameron Casacci experienced medical complications shortly after his birth on Sept. 11, 2024, including a stroke on the left side of his brain, according to his parents, Brad and Alyssa Casacci. 

He now suffers from seizures and has been diagnosed with medication-resistant epilepsy. His epileptologist in Buffalo has recommended a hemispherectomy, a surgical procedure that disconnects the left hemisphere of the brain from the right, in hopes of eliminating the seizures.

The family says their insurance company initially denied the surgery. 

However, the Casaccis told 2 On Your Side’s Claudine Ewing that the NYS Department of Health sent an email Friday to Independent Health, urging them to reverse their decision of Cam’s surgery in Pittsburgh. The Casaccis say Independent Health contacted them and overturned their denial, allowing them to go Pittsburgh.  Baby Cameron is now scheduled to have his surgery in Pittsburgh on August 20. 

When 2 On Your Side contacted Independent Health for  response, they sent this statement: 

“As a Medicaid managed care plan, we follow federal and state laws, including New York State’s Medicaid rules, which generally do not allow out-of-area or out-of-state coverage of Medicaid health care services unless the service cannot be provided by an in-network provider. When denials occur, Independent Health works with Medicaid members to connect them to in-network providers and facilities capable of delivering the care needed. We adhered to these rules when we issued our decision and directed this member to qualified and highly skilled in-state practitioners capable of providing these health care services.

 “In this important case, Independent Health has been actively communicating with the New York State Department of Health. The Department acknowledged the general requirement that Medicaid members receive services from in-network providers; however, given the rare nature of the procedure requested in this case, the Department has granted us flexibility to approve the procedure at the facility requested by the member without the need for further appeal or delay.  

“Federal law (HIPAA), New York State law, and our internal confidentiality policy prohibit us from disclosing additional information related to a member’s protected health information.”