Patient commits suicide after ‘insurance glitch’ delayed treatment for lung disease flare-ups

Kyle, TX — Kenney Blewett was diagnosed with lung disease more than a decade ago, but started having flare-ups this year that left him feeling like he couldn’t breathe.

Blewett described the flare-ups as “the scariest thing in the world,” said his wife, Cindy, adding that although the episodes usually lasted no more than a few minutes, they had become more frequent.

On top of that, simple tasks, like taking out the trash, left Blewett out of breath. He rarely left the house and had recently lost 45 pounds. “It looks like cancer,” Cindy recalled, according to one of her doctors. It was clear, she said, that her husband’s poor health, linked to decades of smoking, was getting worse.

So on June 2, Blewett’s pulmonologist prescribed a new medication to improve the terrifying breathing problems caused by chronic obstructive pulmonary disease, or COPD. But the order was not immediately implemented. Two days after that doctor’s appointment, Blewett received an email from Walgreens explaining that “due to an insurance issue we are trying to resolve,” treatment had been delayed.

“He hoped it would work,” Cindy said of the drug, two months after her husband’s death. “I wish we had the chance to find out.”

Insurance delays and denials have become an infamous feature of the U.S. health care system, with nearly 7 in 10 adults calling them a “major problem” in a KFF health tracking poll in January.

In June 2025, six months after the assassination of UnitedHealthcare’s CEO in New York, the Trump administration announced a high-profile industry pledge, signed by dozens of major health insurers, aimed at removing some of the barriers that block or delay patients’ access to doctor-recommended care. And yet, this commitment was voluntary and does not result in any sanctions if companies do not comply. Indeed, a report published by KFF Health News in July revealed that some insurers who signed the pledge would not implement all promised initiatives as initially planned.

In recent years, lawmakers in most states, including Texas, have attempted to address delays and denials by regulating the insurance industry in the absence of substantive federal reforms. But most health insurance plans, including traditional Medicare policies and employer-sponsored offerings, which together cover more than half of Americans, are generally outside of state jurisdiction.

Even some staff at doctors’ offices and pharmacies find the patchwork of state and federal insurance rules and regulations confusing, a problem that is poised to get more complicated as artificial intelligence plays a larger role in approving and processing claims.

“This has gotten completely out of control,” said Matt Toresco, CEO of Archō, a consulting and patient advocacy firm. He argued that patients need more assistance navigating insurance barriers.

The Blewetts’ story illustrates how navigating these complexities remains a Herculean task for patients and their caregivers.

Cindy sought answers from Medicare, Kenney’s Part D private drug plan, her pulmonologist’s office and Walgreens. She still wonders who is responsible for the delay in medication and how the delay could have been avoided.

If the COPD flare-up Blewett experienced on the afternoon of Sunday, June 7, had been preventable, she wondered, would he still have chosen to kill himself that night?

“Complex and convoluted”

During that first week in June, Cindy said her husband asked her several times if her prescription — a liquid medication meant to be inhaled through the nebulizer owned by Kenney — was ready for pickup at Walgreens.

Cindy said she was not initially surprised or concerned by the delay. Since its acquisition by a private equity firm last year, Walgreens has cut thousands of jobs across the country, according to the Private Equity Stakeholder Project. Cindy said in August that their Walgreens pharmacy in Kyle seemed to have been understaffed for months and prescriptions were being filled more slowly.

When Cindy called the pharmacy a few days after Kenney’s appointment to inquire about the insurance delay, she said, a Walgreens employee told her the prescription required prior authorization. Also called preapproval or precertification, prior authorization is a practice widely used by health insurers that requires medical providers to seek authorization before their patients can receive covered treatment.

But Cindy didn’t know which of Kenney’s insurers required prior authorization for the drug.

For years, she helped manage several policies in her husband’s name. Kenney was insured by Medicare Parts A and B, the federal health insurance program for people 65 and older or disabled. But he also had a private Part D plan to cover drug costs through Wellcare Value Script, as well as a Medicare Supplement plan through Blue Cross and Blue Shield of Texas — also called a “Medigap” plan — that paid other costs.

Initially, Cindy assumed that Kenney’s Part D plan had invoked prior authorization for his new drug. But because it was a liquid inhaled via a nebulizer, the drug was one of the few covered by Medicare Part B’s durable medical equipment benefit, not Part D.

The federal government had no record showing that this prescription had been billed under Kenney’s Part B policy, the Medicare agency told Cindy over the phone, she said.

Sarah Tanner and Myriea Amaya, spokespersons for Centene, the parent company of Wellcare Value Script, did not respond to questions for this article.

After Kenney’s death, when Blewett asked the Walgreens pharmacy for clarification, she said the employee “kept saying different things.” She remembers his explanation that the prescription had been submitted to Medicare Part B but without the necessary diagnosis code that the doctor should have included.

Carmen Lopez, a spokesperson for Walgreens, told KFF Health News in late September that the company “cannot comment on matters involving specific individuals.”

Afterward, Cindy said, a Walgreens district pharmacy supervisor contacted him by phone and told him the pharmacy had attempted to process the prescription through Part B on June 2, the same day as the pulmonologist appointment, but the prescription was missing a doctor’s diagnosis code. The supervisor said Walgreens sent a request for that code to the pulmonologist’s office later that day, Cindy recalled.

Kenney’s pulmonologist – Rajesh Shetty of LungDocs – did not respond to phone or email messages from KFF Health News. But Cindy said a practice employee told her he hadn’t seen a fax from Walgreens asking for a diagnosis code for the prescription.

Meanwhile, this couldn’t have been an issue with Kenney’s Medigap plan, since those policies don’t require prior authorization.

“Short of involving lawyers,” Cindy said, “I don’t know how to find out what really happened.”

Even more administrative formalities to come

Confusion around these distinctions between Parts B and D is common, said Mike Hess, senior director of patient outreach and education at the nonprofit COPD Foundation. “Medicare has become so complex and convoluted over the years,” he said, that even medical office staff and pharmacy employees often misunderstand its nuances.

And with the introduction of AI into the pre-approval process, overcoming barriers to insurance will likely become more complex for Medicare beneficiaries, doctors say.

Historically, traditional Medicare, unlike Medicare Advantage, used prior authorization sparingly. But in January, Medicare launched a pilot program in six states — Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington — testing the use of AI to pre-approve certain health services.

Its goal is to “eliminate the waste of original Medicare,” CMS Administrator Mehmet Oz said, but doctors and patients say the program creates more red tape for Medicare beneficiaries and leads to inappropriate denials. The pilot program does not currently impose prior authorization requirements for COPD medications, but industry experts expect the initiative’s reach to expand to include more departments and states.

On the night of June 7, hours after her husband’s last COPD flare-up, Cindy Blewett was sitting on their back porch when she heard a loud noise. She assumed a photo had fallen off the living room wall. In fact, it was a gunshot. She discovered Kenney’s body in their bedroom.

“I can’t tell you how horrible it was,” Cindy said.

She said her husband had suffered from mental health issues for a long time and had previously attempted suicide once, years ago. Her deteriorating health only made things worse, she said.

Kenney confirmed this in a note he left. He told Cindy that she was a wonderful wife, mother and grandmother, but that her health was too poor to continue living.

A second drug against COPD, which his pulmonologist ordered directly from the drug manufacturer during the appointment on June 2,…