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Anthem Blue Cross Challenged In Court

Audio

Aired 2/25/10

The organ transplant policies of Anthem Blue Cross are being challenged in a Los Angeles court room. A patient is accusing the insurer of automatically denying his request for an out-of-network liver transplant.

— The organ transplant policies of Anthem Blue Cross are being challenged in a Los Angeles court room. A patient is accusing the insurer of automatically denying his request for an out-of-network liver transplant.

Anthem approved the man's liver transplant in California, but the patient was told he may have to wait up to two years for a donated organ. So he decided to go to Indiana, where the waiting list was only six weeks. Anthem said it wouldn't pay for the operation. The man paid for it himself.

Depositions reveal Anthem doctors didn't examine the patient, and didn't consult with his physicians.

Bryan Liang is with the California Western School of Law.

"You start to question whether those decisions were made on the basis of medical appropriateness," says Liang, "Or, quite honestly, to make the insurer reduce its costs and increase its profits."

Anthem maintains it acted appropriately. The insurer says the patient's policy only covered transplants in contracted hospitals.

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