By: Hall	S.C.R. No. 30

	SENATE CONCURRENT RESOLUTION
	WHEREAS, Barbara Stegall, individually and as representative
	of the estate of Joe Stegall, alleges that:
	(1)  in the spring of 2014, Joe Stegall began
	experiencing fevers and a feeling of being unwell;
	(2)  Mr. Stegall was employed as the chief financial
	officer for the City of Royse City, Texas, and as a city employee,
	was eligible for, and participated in, the city's medical and
	prescription drug insurance provided by the Texas Municipal League
	and TML MultiState Intergovernmental Employee Benefits Pool, Inc.;
	(3)  the Texas Municipal League and TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., provided medical
	and prescription drug coverage to Joe and Barbara Stegall, and UMR,
	Inc., was the third-party administrator;
	(4)  in May 2014, Mr. Stegall felt ill, and was taken to
	the hospital by Mrs. Stegall and was admitted, examined, and
	informed that he had cholangiocarcinoma, more commonly known as
	bile duct cancer;
	(5)  Mr. Stegall returned home to form a treatment plan
	with his oncologist, Dr. Ahmer Younas at Texas Oncology in Rowlett,
	Texas, and made an appointment with a second oncologist,
	Dr. Douglas Orr at Texas Oncology in Dallas, Texas;
	(6)  in subsequent appointments, Dr. Younas and
	Dr. Orr advised Mr. Stegall that he had cholangiocarcinoma, bile
	duct cancer, and hepatocellular carcinoma, liver cancer;
	(7)  Dr. Younas advised Mr. Stegall to start
	chemotherapy for the bile duct cancer first and add another form of
	chemotherapy for the liver cancer at a later date, and Mr. Stegall
	promptly began a chemotherapy regimen of gemcitabine and cisplatin
	to treat the bile duct cancer;
	(8)  as a result of the positive response Mr. Stegall
	exhibited to chemotherapy, on October 23, 2014, Dr. Younas
	recommended that Mr. Stegall add to his chemotherapy regimen
	another drug that would target the liver cancer;
	(9)  Dr. Younas prescribed sorafenib, known in the
	United States by the brand name Nexavar, in tablet form to treat the
	liver cancer, and sought authorization for the drug from the Texas
	Municipal League and TML MultiState Intergovernmental Employee
	Benefits Pool, Inc.;
	(10)  Nexavar is FDA-approved for the treatment of
	hepatocellular carcinoma, from which Mr. Stegall suffered, and
	Nexavar increases the survival rates and life expectancy of
	patients with advanced liver cancer;
	(11)  the Texas Municipal League and TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., refused to
	authorize the drug for Mr. Stegall, and on October 30, 2014, a
	written denial signed by Carol Padgett, RN, BSN, CCM, Medical
	Intelligence Care Management, on TML MultiState Intergovernmental
	Employee Benefits Pool, Inc., letterhead was sent to Mr. Stegall,
	at the address of Texas Oncology, citing as the basis for the denial
	that, "The requested service was determined to be unproven.";
	(12)  Dr. Younas persisted in efforts to obtain
	chemotherapy for Mr. Stegall and engaged in a telephone conference
	with Dr. Philip Schulman, an employee or agent of the Texas
	Municipal League, TML MultiState Intergovernmental Employee
	Benefits Pool, Inc., or UMR, Inc.;
	(13)  Dr. Younas learned that Dr. Schulman, and by
	extension, the Texas Municipal League, TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., and UMR, Inc., did
	not believe that Mr. Stegall had liver cancer;
	(14)  due to the urgency of Mr. Stegall's need,
	Dr. Younas and his staff immediately began efforts to procure
	Nexavar for Mr. Stegall without insurance and at no cost to
	Mr. Stegall through a Resources for Expert Assistance and Care
	Helpline program;
	(15)  the Texas Municipal League and TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., acted
	intentionally to discourage Mr. Stegall from obtaining Nexavar;
	(16)  on November 5, 2014, PMC Multistate Case Manager
	Carol West, an employee or agent of the Texas Municipal League, TML
	MultiState Intergovernmental Employee Benefits Pool, Inc., or UMR,
	Inc., advised Dr. Younas's staff that the Texas Municipal League
	and TML MultiState Intergovernmental Employee Benefits Pool, Inc.,
	would terminate all of Mr. Stegall's future coverage if he took
	Nexavar and experienced complications from it;
	(17)  the communication caused Mr. and Mrs. Stegall to
	believe that the Texas Municipal League and TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., were looking for
	reason to cease payment for Mr. Stegall's treatment, and that any
	attempt to circumvent coverage decisions by the Texas Municipal
	League and TML MultiState Intergovernmental Employee Benefits
	Pool, Inc., would be met with immediate termination of all
	benefits;
	(18)  the attempt of the Texas Municipal League and TML
	MultiState Intergovernmental Employee Benefits Pool, Inc., to
	cease coverage for Mr. Stegall's treatment, and allow his death,
	had a devastating impact on Mr. Stegall's demeanor and spirit, and
	caused both Mr. and Mrs. Stegall severe mental distress;
	(19)  on November 11, 2014, Dr. Younas's staff was
	contacted regarding difficulties verifying the status of
	Mr. Stegall's insurance coverage, and Dr. Younas's office
	responded by resubmitting the authorization request for Nexavar to
	confirm the absence of coverage;
	(20)  on November 21, 2014, the Texas Municipal League
	and TML MultiState Intergovernmental Employee Benefits Pool, Inc.,
	suddenly and without explanation, reversed course and authorized
	the Nexavar;
	(21)  the coverage decision was conveyed in a telephone
	call initiated by Dr. Younas's office, and the Texas Municipal
	League and TML MultiState Intergovernmental Employee Benefits
	Pool, Inc., did not take any affirmative steps to notify
	Mr. Stegall of its change in decision;
	(22)  for Mr. Stegall and his family, the reversal came
	too late, and over the course of four excruciating weeks, during
	which time Mr. Stegall, Dr. Younas, and Dr. Younas's staff worked
	tirelessly to obtain the Nexavar, Mr. Stegall's condition
	worsened;
	(23)  Mr. Stegall was admitted to the hospital on
	Friday, December 12, 2014, where he died four days later;
	(24)  the Texas Municipal League and TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., and its agents,
	including UMR, Inc., denied Mr. Stegall access to Nexavar both
	directly by denying coverage and indirectly by threatening to end
	all coverage if he obtained Nexavar without the approval of Texas
	Municipal League and TML MultiState Intergovernmental Employee
	Benefits Pool, Inc., or UMR, Inc., thus denying Mr. Stegall
	coverage to which he had a contractual right, as well as the medical
	benefits of timely access to the Nexavar;
	(25)  the wrongful and intentional acts of the Texas
	Municipal League, TML MultiState Intergovernmental Employee
	Benefits Pool, Inc., and UMR, Inc., ultimately caused Mr. Stegall's
	premature death on December 16, 2014, at the age of 60;
	(26)  the actions of the Texas Municipal League, TML
	MultiState Intergovernmental Employee Benefits Pool, Inc., and
	UMR, Inc., demonstrate gross negligence and a wilful intent to
	deprive Mr. Stegall of the benefits of his coverage and of his life
	for the sake of financial economy; and
	(27)  the Texas Municipal League, TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., and UMR, Inc., must
	be held liable; now, therefore, be it
	RESOLVED by the Legislature of the State of Texas, That
	Barbara Stegall is granted permission to sue the Texas Municipal
	League, TML MultiState Intergovernmental Employee Benefits Pool,
	Inc., and UMR, Inc., for wrongful death, negligence, breach of
	contract, breach of the duty of good faith and fair dealing, and
	violations of the Texas Insurance Code and Texas Deceptive Trade
	Practices-Consumer Protection Act, subject to Chapter 107, Civil
	Practice and Remedies Code; and, be it further
	RESOLVED, That if Barbara Stegall is successful in proving
	her allegation against the Texas Municipal League, TML MultiState
	Intergovernmental Employee Benefits Pool, Inc., and UMR, Inc.,
	Mrs. Stegall is entitled to an award of actual, compensatory, and
	statutory damages and reasonable attorney's fees and costs
	authorized by law; and, be it further
	RESOLVED, That the suit authorized by this resolution shall
	be brought in Dallas County; and, be it further
	RESOLVED, That the attorney general, the Texas Commissioner
	of Insurance, the executive director of the Texas Municipal League,
	and the chairman of the board of TML MultiState Intergovernmental
	Employee Benefits Pool, Inc., be served process as provided by
	Section 107.002(a)(3), Civil Practice and Remedies Code.