Class Action Challenges Anthem's Eating Disorder Guidelines

Posted By Kantorlaw || 26-Mar-2014

Shelby Oppel and Bryndis Klein, for themselves and for all other similarly situated California residents vs. Anthem Blue Cross Life & Health Insurance Company

This lawsuit, recently filed by Kantor & Kantor, LLP, alleges that Anthem Blue Cross Life & Health Insurance Company and Blue Cross of California have persistently refused to authorize treatment for thousands of suffering eating disorder patients, while continuously violating the following:

This class action challenges Anthem's eating disorder guidelines, which are claimed to be improper and/or unlawful in many ways. Anthem's guidelines utilize internally-developed levels of care for eating disorders, created by committees within Anthem, which do not meet generally accepted standards of medical practice. These guidelines are not objective or impartial, rather they make use of compromised doctors who have serious disciplinary records, multiple lawsuits, are in financial distress or have filed for bankruptcy, have inappropriate and conflicted relationships (including family, social and business relationships) with other Anthem peer review physicians, and/or are clinically inexperienced. Furthermore, Anthem's denial letters are sent out with "robosignatures" - electronic signatures of Anthem physicians who did not actually review the file and did not participate in the benefit determination or authorship of the denial letters in any way.

Ms. Oppel and Ms. Klein bring this action for themselves, and for all similarly affected California residents, with the intent to eliminate unnecessary gaps in treatment, mandate compliance with parity and APA guidelines, and rid Anthem of their outdated, internally developed, and pre-determined guidelines. Anthem's focus should be to utilize qualified and objective reviewing physicians in making reasonable decisions about the most appropriate level of care for each patient; rather than focusing on denying care and saving costs.

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