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Insurers Face More Suits Over Post-Cancer Breast Operations

Nov. 20, 2019, 11:56 AM

Insurers face an uptick in lawsuits claiming they failed to fully reimburse post-mastectomy breast reconstruction surgery, even though a federal women’s health law requires them to do so. A Bloomberg Law analysis found seven such cases filed since May against Blue Cross Blue Shield subsidiaries, Aetna, and UnitedHealthcare.

Holding the Bag: These disputes between plastic surgeons and insurers are seen as part of a larger trend. Attorneys say insurers routinely find ways to reduce reimbursements, leaving surgeons with big bills that they have to absorb or pass on to patients.

Short of Court: Physicians and attorneys say cases challenging reimbursements...

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