>Re-posted from:

Humana Affirms Transplant Integrity — Answers Dr. Linda Peeno —

LOUISVILLE, Ky., April 18 /PRNewswire/ — Humana Inc. (NYSE: HUM) today issued a statement affirming its commitment to providing quality affordable health care for its health plan members — including those in need of heart transplants.

“Humana has always strived to assure that no covered beneficiary was denied a medically appropriate heart transplant. We have demonstrated a record of integrity and innovation in the area of heart transplantation,” said Humana corporate spokesman Greg Donaldson. “Humana offers heart transplants as a standard benefit of Humana health plans.”

In 1996, Humana approved 46 heart transplants and denied none. Humana transplants are performed at nationally recognized transplant centers,including Johns Hopkins, the UCLA Medical Center, Barnes-Jewish Hospital in St. Louis and the Loyola University Medical Center in Chicago.

“We believe in providing the right care, at the right time, in the right setting,” said Dr. Jerry Reeves, MD, Humana Chief Medical Officer. “All health care professionals should be held accountable for the quality of the services they provide.”

Humana provides an exhaustive appeals process for health plan members who believe they may have been denied care for any reason. This process is intended to protect the rights of health plan members. Humana’s quality management program is an award-winning industry leader. The National Committee for Quality Assurance has so far accredited nine Humana health plans.

Humana believes that the kind of coordinated care the company offers can improve quality of life and save lives. “Ours is a better way to deliver health care,” said Dr. Reeves. “We believe in partnering with patients and physicians to improve health. This means improving quality through accountability, supporting informed decisions by patients, supplying affordable care and providing choices among well-qualified physicians. At Humana, we are committed to putting patients first.”

Humana’s statement comes in response to a story told by Kentucky physician Dr. Linda Peeno about a heart transplant request 10-years ago. Dr. Peeno, in news reports, has been quoted as recalling that, while working for Humana, she recommended non-payment for a heart transplant for an unnamed patient who she believes subsequently died. According to news reports, Dr. Peeno has expressed concerns about her past association with various coordinated health care companies.

“Humana believes it is inappropriate to debate today’s health care concerns on the basis of 10-year old stories,” said Donaldson. “We believe this debate is far too vital to be framed outside the context of current medical knowledge.”

Dr. Peeno has not provided the news media with the specific details of the alleged case in question or the name of the patient. As a result, Humana has been unable to properly investigate the facts of the case.

Humana’s review of the records indicates:

— Dr. Peeno was not a Humana employee. She served as a part-time consultant. She averaged 15 hours a week of work for a period of less than nine months before resigning her position in 1987. She was paid a flat hourly rate and received no incentive compensation for any activity.

— Some news accounts have implied that Dr. Peeno might have served as a medical director for Humana and that she was paid six figures for her work. She was not a medical director for Humana. In her short tenure as a part-time contractor with the company, she earned less than $30,000.

— News reports have indicated that Dr. Peeno may have been rewarded for her claims denials by Humana. As a part-time consultant, she received no additional financial reward based on any recommendations.

Headquartered in Louisville, Ky., Humana provides coordinated health care products and services to more than 4.7 million health plan members, making it one of the nation’s largest health care companies.

Humana’s Web site is http://www.humana.com

SOURCE Humana Inc.

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