California Trial in Kaiser Plastic Surgery Coverage Starts

March 17, 2015

A trial in a class action lawsuit over Kaiser Permanente refusal to cover the removal of excess skin for nearly 10,000 patients who underwent weight loss surgery began this week in a California Superior Court in Alameda County.

The Courtroom View Network is reporting that Plaintiff Wendy Gallimore claims that Kaiser Foundation Health Plan Inc. is violating a California law that requires insurers to pay for reconstructive surgery after disfigurement due to disease or trauma.

Kaiser routinely denies such coverage because it considers it elective, according to Gallimore’s suit.

LawsuitAfter bariatric surgery in 2006 Gallimore was left with large amounts of loose skin. Instead of paying to remove the skin, Gallimore says Kaiser referred her to the company’s for-profit cosmetic surgery centers.

An attorney for Gallimore told CVN a ruling in favor of the plaintiff class could leave Kaiser on the hook for coverage of potentially thousands of surgical procedures. An attorney for Kaiser declined to comment.

The case is Wendy Gallimore, et al. v. Kaiser Foundation Health Plan Inc.

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Latest Comments

  • December 22, 2018 at 12:11 am
    d cowles says:
    First of all your an idiot I was diagnosed with an autoimmune disease 4 years ago and I almost died. I wasnt fat I was skinny and then they gave me inusion steriods which caus... read more
  • March 18, 2015 at 1:43 pm
    JJ says:
    So basically they want a free tummy tuck? 99% of these cases are people who made bad choices for years then ask insurance companies to pay the price and fork over for "beriat... read more
  • March 17, 2015 at 2:31 pm
    CSP says:
    They have reclassified growths on the skin as cosmetic in the last two years, with a referal to the Cosmetic Unit. They were for 50 years classed as precancerous growths and ... read more

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