Two people suffering from limb loss sued Anthem, a health insurance company. According to the lawsuit, Anthem wrongfully denied coverage for all devices, claiming they are “investigational and not medically necessary for all indications”. The plaintiffs claim that the devices are not investigational and are necessary for people who have limb loss.
According to the lawsuit, microprocessor-controlled foot-ankle devices use technology to simulate the movements of a normal foot and ankle. They respond to constant feedback from sensors to the microprocessor. The microprocessor then changes the resistance to downward motion and upward motion of the foot based on incline, decline, walking speed, and terrain. The microprocessor makes adjustments in real time. This helps to create stability, decrease stumbles and falls, improve ambulation, and decrease the discomfort and pain associated with a prosthesis.
The lawsuit claims that microprocessor controlled lower limb prostheses are accepted by the medical community as standard. They are routinely prescribed for individuals who meet appropriate medical criteria. The lawsuit claims that Anthem’s claim that the devices are investigational and are not medically necessary is false.
If you have had a request for a prosthetic device denied by Anthem, you may be eligible to join the lawsuit, which is currently ongoing. Call me, Conal Doyle, Los Angeles personal injury attorney at 310-385-0567. My team can help. Call today to learn more or to schedule a free consultation.