Ron Chenoy-US PRESSWIRE
Jason "Mayhem" Miller says the UFC wouldn't pay for his knee surgery, suffered in his final bout for the promotion. This despite there being an insurance policy that is supposed to cover these sorts of injuries. Miller also says he is not the only fighter to have this issue.
In yesterday's video of former UFC fighter Jason Miller and Ariel Helwani talking while walking through Central Park, following a prior bizarre interview where Miller refused to break character, one of the most interesting parts of the interview featured Miller saying that he didn't get surgery on his blown out knee. The knee injury came in his final UFC bout, a loss to CB Dollaway.
The subject of the surgery came up when Ariel and Mayhem were discussing Dana White publicly tweeting that Miller needed medicine during a very public argument.
Miller had the following to say:
"He opened my medical records or something like that? Obviously not, because they gave me a giant runaround when I blew my knee out on high definition, live on...FX.
They wouldn't pay my surgery."
After being asked "they didn't pay for it? Wasn't there insurance?" Miller said:
"I didn't get one [surgery]. ...you know, I went and got an MRI, it was kind of a hassle, they kept rescheduling for some reason, then I finally got the MRI. I make an appointment, I go all the way to L.A., an hour and a half in traffic, I go to a doctor and he said 'I don't have your MRI's. Did they give you a disc?' No, why would they give me a disc? There's this new thing out, doc, I don't know if you've heard of it, it's called the internet. You can just send things. I'll let you sign into my Dropbox account.
And I knew what the deal was immediately. And I said it and he gave an 'affirmative' with his silence. So...when they don't need you anymore they just toss you out...they just give you a runaround until you give up on that knee surgery.
I already know from watching my fellow fighters how hard it is to get it when you're just a low guy on the roster. How difficult it is. I watched Krzysztof Soszynski running back and forth trying to get...he gave his whole body, he gave his whole fucking body for the entertainment for the masses. His knees are fucked, he's got weird...this that and the other. We all do because we chose this lifestyle. ..but guess what? Get a job Krzysztof.
I'm just wondering about these other kids. Eventually, they're going to be old and...sorry, hopefully someone sets up a school and you become a plumber when you're done doing MMA."
So Miller is basically saying that there was some sort of effort to keep him from getting surgery despite the UFC "insurance" policies and the injury happening in a UFC bout. He also says that he's seen it happen to multiple other fighters and specifically names Krzysztof Soszynski.
I don't want to editorialize too much here because it's hard to really understand all the specifics from what Miller said. Was it actually just a case of different medical offices not being on the same page? Was it actually a concentrated effort by the doctors, insurance companies and/or the UFC?
I did reach out to the UFC asking for a statement on Miller's comments, but they have declined to comment.
After writing this article last night and scheduling it to post this morning, Dana White did go to The Underground and posted an e-mail from their medical claims manager covering the treatment that Miller did receive.
There is a major problem here in terms of HIPAA (Health Insurance Portability and Accountability Act). You can't make medical records public (you can't even tell people that a patient visited an office, let alone give specifics) without clear written permission.
There was actually a similar case in late 2011/early 2012 with a hospital releasing a patient's medical records to the media after the patient was "quoted on the record" about her care. Here's how that went for them:
The office of civil rights of the U.S. Department of Health and Human Services, which enforces HIPAA, put it this way: "There is no 'waiver' that would apply to the release of a chart or medical record to the media without an individual's written authorization."
Several experts told me it doesn't matter if the hospital was trying to contradict misinformation provided by a patient (even if that's what Courtois did, which is debatable). Under the law, patients themselves can divulge anything they wish about their medical conditions and their treatment by a hospital. But a hospital's obligation is to keep its mouth shut. A desire to deflect bad PR is not an excuse. Even if they think they're in the right, the law says healthcare providers have to suffer in silence, the experts say.
I've reached out to the UFC for a comment on their president's decision to release medical information from an insurance company in public.
Update: There are some questions over if the UFC, as an employer, is actually a "covered entity" for HIPAA. At the very least there are very clear privacy law violations on Dana's part.
But I still think there is a good chance HIPAA applies as the UFC has their own medical claims manager (Briana Mattison from the e-mail Dana posted) who is in their employ. So they went to their own employee, who handles medical claims, to get information about an ex-employee and then released that publicly. The fact that they have an employee in their organization who handles the information would seem to make this fall within guidelines of HIPAA.
Even if HIPAA ends up not applying, there are no end to privacy laws that would handle public disclosure of medical information by an ex-employer.
Update 2: As posted by our own Zombie Prophet in the comments (linking to this article):
Normally, an employer will only deal with covered entities, not actually be one. However, if an employer has any kind of health clinic operations available to employees, or provides a self-insured health plan for employees, or acts as the intermediary between its employees and health care providers, it will find itself handling the kind of PHI that is protected by the HIPAA privacy rule.
It would seem that having a medical claims manager in their employ who acts as an intermediary between the medical offices and the fighters, that puts them into "being a covered entity" but we're trying to get confirmation on that from a legal source.