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Blue Cross Sued on Secret Policy for Medical Denials

LOS ANGELES (CN) - A class action was filed Friday by Jeanine and Sanjay Kumar alleging Blue Cross improperly denies payment for the use of Avastin for the treatment of ovarian cancer even though it is medically necessary. Blue Cross also has a practice of denying claims based on undisclosed guidelines and at variance with the stated coverage provided to subscribers, according to the complaint. And the company fails to inform subscribers of their right to independent medical reviews of coverage denials based on the experimental and investigational treatments. Denial letters are alleged to be affixed with electronic signatures of "medical directors" who have not reviewed any materials. Filed by Michael Bidart with Shernoff Bidart.

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