View this article online: https://www.insurancejournal.com/news/west/2015/03/17/360828.htm
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.
After 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.