Anthem Can’t Dodge Proposed Class Action Over Prostheses Coverage

Anthem Inc. must defend a lawsuit accusing it of wrongfully denying coverage for microprocessor controlled prostheses—artificial extensions that replace missing body parts.

Anthem is a proper defendant because of the control it exercised in developing and implementing the criteria that must be met before an insured’s request for a prosthesis with a microprocessor is granted, Judge Otis D. Wright II of the U.S. District Court for the Central District of California held Jan. 19.

The lawsuit, filed by two insureds who were denied coverage for microprocessor controlled knee devices, seeks to represent other similarly situated insureds. Anthem allegedly has ...