Blue Cross and Blue Shield of Massachusetts, Inc. will pay between $5,000 and $88,875 to class members who allege the insurer misled them when it denied coverage for their children’s out-of-network residential mental health services.
There are more than 200 members in the proposed settlement pay class, according to an initial approval motion filed Nov. 23 in the US District Court for the District of Massachusetts.
The lawsuit alleges that BCBSMA, which insured or administered the health care plans, misled families by citing “alleged exclusions” in coverage denial letters, instead of identifying the actual, specific reasons for the denial in violation of the Employee Retirement Law. Income Security Law.
- The agreement also provides for injunctive relief, which the plaintiffs say will provide families with the information they need to file a meaningful appeal.
- When denying authorization for services in a residential program, BCBSMA will provide, for at least two years, “the specific facts and factors that BCBSMA evaluated.”
- Class counsel says that BCBSMA has also agreed to pay fees and costs of up to $3.6 million.
Judge Allison D Burroughswho chairs the case, must approve the proposal before it goes forward.
The plaintiffs are represented by Glancy Prongay & Murray LLP, Rosenfeld & Rafik PC, Brian S. King of Salt Lake City, Utah, and the Law Offices of Sean K. Collins and Jonathan M. Feigenbaum, both in Boston.
BCBSMA, along with Blue Cross and Blue Shield of Massachusetts HMO Blue Inc., is represented by Morgan Lewis & Bockius LLP.
the case is Brent S. v. Blue Cross Blue Shield of Mass.D. Mass., No. 1:17-cv-11569, motion 11/23/22.
