Health Net Sued Over ‘Medically Unnecessary’ Coverage Denials
Some Californians are suing Health Net over the insurer's refusal to cover some treatments after it deemed them medically unnecessary.
Los Angeles Times: Health Net Faces Suit Over Refusals To Cover Treatments
Robert Mendoza of Monrovia says he had to come up with about $30,000 last year to pay for a cancer surgery that his insurer, Health Net Inc., refused to cover because it wasn't considered "medically necessary" (Terhune, 9/13).
Reuters: LA Doctors, Patients Sue Health Net For Denying Claims
The group representing Los Angeles doctors has joined with two patients to sue Health Net Inc for denying claims based on the insurer's definition of "medical necessity." The lawsuit, filed in Los Angeles Superior Court, accuses Health Net of unfair and unlawful business practices. The managed care plan operates mostly in the western United States and has 2.3 million members in California (Beasley, 9/13).