According to a class action lawsuit filed late last year in California, Blue Shield of California (also known as California Physicians’ Service) has a practice of denying coverage for some lower limb devices. The company has also been accused of restricting payments for lower limb devices if the members seek services from an out-of-network provider.
Under the lawsuit, the company is accused of denying coverage for microprocessor-controlled foot prostheses for all of its customers. The company claims that microprocessor-controlled foot prostheses are investigational. Most insurance companies deny coverage for investigational medical treatments or devices.
The lawsuit also alleges that Blue Shield underpays all prosthetists for prosthetic leg components. As a result, the company has a very small network of in-network prosthetists. Customers of Blue Shield are therefore forced in most cases to use out-of-network prosthetists, which results in those customers paying a large portion of the cost of the devices.
If you or a loved one is a customer of Blue Shield of California and has been denied coverage for a microprocessor-controlled foot prosthesis, or if you have been forced to pay for a large portion of your prosthesis under Blue Shield’s insurance plan, call me, Conal Doyle, Los Angeles attorney at 310-385-0567. You may be eligible to join the class action lawsuit. Call today to learn more.