Insurer allegedly, automatically denies request for liver transplant: Trial commences on 22nd Feb

National Health Care Reformers Should Pay Attention to Lawsuit Alleging that Nation's Largest Insurer Denies Liver Transplants Automatically

Who:

Ephram Nehme, Blue Cross enrollee whose liver transplant was denied

Scott Glovsky, Nehme's attorney, the Law Offices of Scott Glovsky

Jerry Flanagan, Consumer Watchdog

When:

12:30 p.m., Monday, February 22, 2010

Where:

Meet outside the Stanley Mosk Courthouse on the courthouse steps at 111 N. Hill St.

The 111 N. Hill St. entrance is located near the intersection of N. Hill St. and W. 1st Street in Downtown Los Angeles.

What:

A trial beginning Monday targeting the nation's largest health insurer, WellPoint Inc., and its California subsidiary, Anthem Blue Cross, for allegedly automatically denying requests for out-of-network liver transplants will help shed light on the need for stronger health reform than is currently being considered, according to Consumer Watchdog.  The group urged President Obama, White House representatives, and the national news media to follow the trial.  

Download the lawsuit filed in Los Angeles Superior Court:

http://www.consumerwatchdog.org/resources/lawsuit.pdf

According to the lawsuit, Blue Cross denied Ephram Nehme's time-sensitive liver transplant at Indiana University hospital even though Nehme's doctor told him that the medically necessary liver transplant would probably not be available in time in California.  The transplant was necessary to save his life.  As a result of Blue Cross's denial, Nehme paid more than $205,000 out of pocket for the surgery.  According to the lawsuit documents, Blue Cross denied the procedure without speaking with any of Nehme's doctors or reviewing all of Nehme's medical files.  A Blue Cross transplant nurse recommended that Blue Cross cover the Indiana transplant before the insurance company denied the claim.

Read Consumer Watchdog's letter to Congress demanding new legal accountability of the health insurance industry: http://www.ConsumerWatchdog.org/resources/PatientsBillofRightsHouseSenate.pdf

Read about why 50 million Americans don't have the same rights as other patients to hold their health insurer accountable for denials of care: http://www.consumerwatchdog.org/patients/EqualJusticeForPatients/

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