A lawsuit was filed last fall in federal court in California, alleging that Anthem, a health insurance provider, wrongfully denied claims for microprocessor controlled protheses for customers who had suffered lower limb loss. The lawsuit claims that the denials were in violation of federal employment benefit laws.
Anthem has a coverage guideline called the Anthem Medical Policy on Microprocessor Controlled Lower Limb Prostheses, which the lawsuit alleges the company has used to deny most medical requests for the devices on the basis that they are not medically necessary. The company also claims that they are investigational devices, and therefore do not have to be covered under the policies.
According to the lawsuit, Anthem’s actions violate ERISA, which is a federal law that regulates employee benefits under employee benefit plans. The lawsuit is seeking to be certified as a class action and is seeking all people covered under Anthem plans whose requests for microprocessor-controlled knee or foot-ankle prostheses have been denied.
If you or a loved one has been a customer of Anthem in the past and have had your claim for a microprocessor controlled lower limb prothesis denied, call me, Conal Doyle, Los Angeles class action attorney at 310-385-0567. I am one of the attorneys who is involved in the lawsuit, and I can help walk you through your legal options. Call today to learn more or to schedule your free consultation.