Emergency Physicians Expose Anthem’s Unlawful Emergency Care Policy with New Video


The American College of Emergency Physicians (ACEP) launched a new video to push back on a dangerous policy by Anthem Blue Cross/Blue Shield (BCBS) to deny coverage for emergency patients in six states, Indiana, Georgia, Kentucky, Missouri, New Hampshire and Ohio. If the insurance giant decides your visit to the ER was not an emergency, based on their undisclosed lists of diagnoses, they’ll leave patients with the entire bill.

“Anthem’s policy has deadly serious implications for patients,” said Paul Kivela, MD, FACEP, president of ACEP. “Anthem is risking patients’ lives by forcing them to second guess their medical symptoms before they get to the ER, and some may not go when they need to. As the video explains, people may have identical symptoms but have different diagnoses — one life threatening, one non-urgent. Insurers cannot reasonably expect patients to know the difference.”

The company is using secret lists of pre-determined diagnoses — which Anthem BCBS considers to be “non-urgent” — that may not be covered if the patient goes to the emergency department. In Missouri, the original list of nearly 2,000 diagnoses included “influenza,” — which has killed several people this season — “ovarian cyst” and “blood in the urine,” which can be symptoms of medical emergencies.

In December, Sen. Claire McCaskill, D-MO, representing a state where Anthem implemented this policy, sent a letter to Anthem’s CEO requesting answers and internal documents from the company.

“Patients are not physicians,” said Sen. McCaskill in the letter.  “I’m concerned that Anthem is requiring its patients to act as medical professionals when they are experiencing urgent medical events.”

Learn more at www.faircoverage.org.

 

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