Lifesaving Heart Surgery Denied For Orange County Boy

ORANGE COUNTY, CA — Noah Connally is almost 4 years old. He loves superheroes. He hates hospitals. But Noah was born with an underdeveloped left ventricle, a condition called hypoplastic left heart syndrome, and so he needs to go the hospital — often.

Recently, he was medically approved for a procedure that will improve his ventricles and allow him a long-lasting life. On the way to that procedure, in Boston, the family learned that the insurance company denied coverage for the procedure.

The reason, according to Anthem Insurance's denial letter, was because Boston Children's Hospital was outside of their plan network.

"Your plan does not cover services given by a provider that is outside of the plan network except where we do not have a provider in our network that has the same skills," Anthem wrote. "Your plan network has advanced network providers with the same skills who are able to provide the requested service."

His mother will not take no for an answer.

His parents have not yet canceled the Thursday, Aug. 8, surgical appointment at Boston Children's Hospital. The denial of coverage is, as they see it, just one more hurdle in his journey. Parents Niccole and Sean Connally, as well as Noah's four sisters, are hoping for a miracle.

"It took a village to send us to Boston," Niccole Connally told the Orange County Register. "It breaks my heart to even think that Noah might not get this surgery."

Noah's journey has been long, his mother explained to Boston's WBZ-TV. Niccole Connally was 20 weeks pregnant when they found out about his heart condition.

"We were asked to terminate. That was never an option for us," she said.

Noah had his first surgery before he was even born. Since his birth, Noah has undergone two open-heart surgeries.

"Noah only operates on 80 percent oxygen. We feed him primarily through a G- tube. He's limited in his speech, clearly because he's not getting 100% oxygen. He's delayed in other areas," his mother said.

Boston Children's Hospital can reconstruct Noah's heart to make it fully functional, something Anthem Blue Cross in California won't pay for.

"Anthem Blue Cross of California is committed to providing our members with access to quality and affordable health care services and support to help manage their health needs. Anthem Blue Cross' provider network includes many nationally recognized facilities that excel in treating patients with challenging, highly-complex medical needs," a company spokesperson said in a statement to WBZ. "Many insurance products, including network based HMOs, do not cover services performed by providers that are not in the insurer's network, regardless of medical necessity, unless services are not available in network."

Niccole Connally says the insurer "offered us a third stage surgery which will lead to transplants in Noah's future. We're not willing to give up the best for their mediocre opportunity."

Like any parents, the Connallys want the best medical care for their son that they can get.

"We can have heart surgery in California, but we can't have this heart surgery in California," she said. "I just want what every mom wants. I want my son to outlive me. This is the surgery he needs at Boston Children's."

The Connallys, both teachers and parents of five, are praying for a successful 10-hour surgery Thursday and asking for help paying the million-dollar hospital bill. As of this report, they have raised just over $65,000 on their GoFundMe page.

Follow their story on Noah's Facebook page, and remember to Pray for Noah's Heart.

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