A lawsuit that was recently filed against Blue Shield of California, an insurance company, alleges that the insurance company wrongfully refuses to provide its customers with microprocessor-controlled foot prostheses. The lawsuit alleges that the company overlooks medical studies and other evidence in order to deny claims for the devices.
Blue Shield has written and implemented written positions on coverage on various devices, including microprocessor prostheses. Blue Shield has a medical policy called “Microprocessor-Controlled Prostheses for the Lower Limb”. The medical policy for Blue Shield states that microprocessor-controlled lower limbs are considered investigational.
However, the lawsuit alleges that studies have shown that microprocessor-controlled foot prostheses provide significant benefits over mechanical feet, and that Blue Shield’s medical policy ignores studies that show the benefits of microprocessor technology. The lawsuit claims that microprocessor devices respond to constant feedback from sensors, which allow for a more normal bend at the ankle when walking. This can reduce stumbles and falls and also can reduce pain.
Unfortunately, Blue Shield has continually denied most claims for microprocessor-controlled prostheses, which ultimately necessitated a lawsuit. If you have suffered limb loss and have had your claim for a prosthesis denied by Blue Shield, call me, Conal Doyle, Los Angeles class action attorney. I am involved in this lawsuit and can help explain your legal options. You can reach me at 310-385-0567.