BRIDGEPORT, W.Va. — Eric Tennant, a 58-year-old safety instructor from Bridgeport, West Virginia, battled his health insurer for months earlier this year to obtain coverage for a doctor-recommended cancer treatment, according to reports by KFF Health News and NBC News.
Tennant was diagnosed in 2023 with stage 4 cholangiocarcinoma, a rare cancer of the bile ducts that had spread to his bones. By early 2025, after grueling chemotherapy that slowed the disease's progress but severely affected his quality of life, his oncologist identified him as a candidate for histotripsy, a noninvasive procedure that uses targeted ultrasound waves to destroy liver tumors.
The family hoped the treatment, estimated to cost around $50,000, would extend Tennant's life and provide more time between chemotherapy sessions. However, his insurer, the West Virginia Public Employees Insurance Agency (PEIA), which contracts with UnitedHealthcare for administration, denied coverage multiple times. The denials stated that histotripsy was “not medically necessary,” according to insurance paperwork cited in the reports.
Tennant, insured through his employment with the West Virginia Office of Miners’ Health Safety and Training, and his wife Rebecca appealed the decision four times. They navigated a process involving UMR, a UnitedHealthcare subsidiary, and an external reviewer, MES Peer Review Services, which upheld the denials.
“It’s a big mess,” Rebecca Tennant said in an April interview. “There’s literally nothing we can do to get them to change. They’re, like, not accountable to anyone.”
The case highlights broader challenges with prior authorization requirements, where insurers review doctor-recommended procedures before approving payment. Health insurers issue millions of such denials annually, often leading to lengthy appeals, particularly for patients with serious conditions like cancer.
Advocates and physicians have raised concerns that the process can delay care for the sickest patients. Studies and reports indicate that many denials are later overturned on appeal, but the delays can be consequential. Insurers maintain that prior authorization helps control costs, prevent unnecessary procedures, and guard against potential harm.
In Tennant’s case, coverage for histotripsy was approved in May 2025 after KFF Health News and NBC News inquired with PEIA about the situation. The agency described the reversal as a “rare and exceptional” situation that did not reflect a change in overall policy.
By then, however, Tennant’s condition had progressed. He died on Sept. 17, 2025, at age 58 from complications related to his cancer.
His widow has since advocated for legislative changes to address prior authorization issues. In March 2026, West Virginia’s governor signed a bill aimed at curbing harms from insurance denials.
Tennant’s family did not expect histotripsy to cure the cancer but viewed it as a chance to improve his remaining time. Details on the current status of related policy changes or other similar cases remain unclear. PEIA and UnitedHealthcare did not immediately respond to requests for comment for this article.
