Anthem Blue Cross of California Accused of Misrepresenting Networks to Members in New Lawsuit

Pasadena, California   July 07, 2014   Business News
(PRLEAP.COM) July 7, 2014 - LOS ANGELES, CA - Anthem Blue Cross of California member Samantha Berryessa Cowart filed a class action lawsuit in Los Angeles to end Anthem's practice of unfairly denying coverage for services that Anthem misled its members into seeking. The lawsuit was just served on Anthem Blue Cross.

Download a copy of the complaint here: www.scottglovsky.com/wp-content/uploads/2014/07/Berryessa.pdf

The class action lawsuit alleges that Anthem Blue Cross misrepresented the providers within its network, according to Scott Glovsky, the lead attorney for Cowart. Anthem sent misleading membership cards to members of Anthem's exclusive provider organization ("EPO"). The membership cards indicated that the members' subscribed to a preferred provider organization ("PPO") plan instead of an EPO plan. "This is significant because in PPO plans members have access to a huge network of Anthem providers and the ability to obtain covered treatment from out-of-network providers. Unlike PPO plans, in EPO plans, members only have access to an extremely limited network of providers and no coverage for out-of-network providers," according to Glovsky.

Many members who received the misleading membership cards sought services from healthcare professionals who accept Anthem's PPO insurance but not Anthem's EPO insurance. When the members then sought coverage for the services from Anthem under their EPO policies, Anthem denied the claims leaving its members to pay out of pocket for the costs.

"Anthem has an obligation to make it clear what doctors and providers are in subscriber networks and when it fails to do so, as it has done with its EPO subscribers, it has an obligation to cover the treatment," said Glovsky.

Anthem has yet to file a response to the complaint in court but it has until early August of 2014 to do so.

About The Law Offices of Scott C. Glovsky
The Law Office of Scott Glovsky is a boutique Pasadena firm with a practice focusing on cases against health insurance companies for the wrongful denial of care. The firm's civil litigation practice focuses on health insurance bad faith, representing children with autism, traumatic injuries, unlawful business practices, and class actions. For more information, go to: www.scottglovsky.com
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