On September 15, 2017, Lacy Atzin and Mark Andersen filed a complaint against Anthem, Inc. for refusing to cover computerized prosthetic devices for knees, feet, and ankles on the grounds that they are not medically necessary. The complaint alleges Anthem incorrectly treated these devices as “investigational,” despite they are accepted by the medical community and routinely prescribed for patients with limb loss.
Anthem Inc. expanded its coverage of computerized knee and foot-ankle prosthetic devices, ending a class-action lawsuit challenging its treatment of these devices as investigational and unnecessary, according to settlement papers filed in California federal court. On August 6, 2021, the parties reached a settlement in principle and are currently working on a written settlement agreement. On November 1, 2021, Anthem filed a NOTICE OF NON‑OPPOSITION to NOTICE OF MOTION AND MOTION for Settlement Approval of Preliminary Approval of Class‑Action Settlement 97. After years of litigation, the settlement provides “substantially all of the relief requested” in the Employee Retirement Income Security Act lawsuit. Anthem has agreed to cover the microprocessor-controlled knee and foot-ankle prosthetics if certain criteria are met. The settlement also allows class members who paid out-of-pocket for their prosthetic devices to resubmit their claims to Anthem if they haven’t already been reimbursed by other insurers or Medicare. Learn more at news.bloomberglaw.com/health-law-and-business/anthem-expands-prosthetic-device-coverage-ending-class-action.