"You Are No Longer Cost Effective"

By Joe Rosato Jr.
|  Wednesday, Mar 24, 2010  |  Updated 6:00 PM PDT
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Vladimir Lopoyan at home in his Tenderloin Apartment.

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In his tiny, cramped apartment in San Francisco’s Tenderloin, Vladimir Lopoyan rifles through a stack of papers the size of an encyclopedia.

He yanked a single paper from the imposing stack and read it excitedly.  "This is the bill from Anthem Blue Cross that Medical is not going to pay for," he said.

Lopoyan opened his medicine cabinet to reveal an assortment of pill bottles. One bottle is for a foot ailment that makes it hard for him to stand for long periods of time. Another is for asthma. Another is for a psychological syndrome related to the AIDS he’s lived with for 20 years. "If you put that together, I’m not well," Lopoyan said.

Last month, the state Of California sent Lopoyan notice that he was being kicked off the Medical HIPP program which helped pay his litany of medical bills and medications.

After protesting, he received a letter from the manager of the HIPP program manager. It read: "The reason you have been terminated from the program is that you are no longer cost effective."

Lopoyan was stunned by the letter’s barren wording. "I felt very hurt," he said. "I felt like they’re just leaving me… just die."

It went on: "A cost analysis was completed and due to your high share of cost you are no longer cost effective to remain on the HIPP program."

The life Lopoyan leads today in his tiny ramshackle flat is worlds away from the life he lived just a year ago. He operated a successful medical billing practice out of his spacious apartment in San Francisco’s Twin Peaks.

First the company failed. Then he lost the apartment. He said he’s moved 26 times since then.  Now his postcard stamp of a room looks out on a brick wall --- a tray of spikes sits in the windowsill to fend of the pigeons which stroll into his room.

And so it is here, Lopoyan fights his battles with insurers, the state and past landlords who he’s taken to court. His pile of papers is the literal paper trail of his recent life.

The victories are few.

But after an inquiry by NBC Bay Area to the California Department of Health Services, Lopoyan got a rare bit of good news.

Responding to a request for comment on Lopoyan’s letter, the state admitted the notice that it was terminating Lopoyan’s insurance was a mistake by staff. The response also addressed the wording of Lopoyan’s letter. "We agree that the correspondence received by Mr. Lopoyan could be perceived as harsh," wrote Anthony Cava from the Department of Health services. "We are working with HIPP staff to resolve this in the future.  DHCS regrets the anxiety caused by both the letter and e-mail Mr. Lopoyan received from the HIPP program."

The department said it is working with Lopoyan to resolve the matter, and clear up any confusion.

But it’s unlikely Lopoyan will take much comfort in the apology. Because in his world, each day reveals a whole new battle.

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