The American College of Emergency Physicians and Medical Association of Georgia this week filed a federal lawsuit seeking to compel Anthem's Blue Cross Blue Shield of Georgia to rescind a policy that retroactively denies coverage for emergency patients. According to the lawsuit, the policy violates the prudent layperson standard requiring insurance companies to cover the costs of emergency care based on a patient's symptoms, not their final diagnosis, and the 1964 Civil Rights Act because the denials disproportionally affect members of protected classes. "ACEP and MAG have tried multiple times to work with Anthem to express these concerns and urge them to reverse this policy, and they have refused,” the organizations said. “We felt we had no choice but to take action to protect our patients, and therefore are asking the federal court to force Anthem's BCBS of Georgia to abide by the law and fulfill their obligation to their policyholders." In March, AHA and other hospital groups also urged Anthem to abandon certain coverage policies for outpatient imaging and emergency care services that are detrimental to patients. 

Related News Articles

Headline
The Congressional Budget Office today released its estimate of the budgetary effects of the One Big Beautiful Bill Act, as enacted. CBO projects the law will…
Headline
Health Insurance Marketplace insurers will propose a median premium increase of 15% for 2026, according to an analysis of preliminary rate filings published…
Headline
The AHA July 3 released the Health Care Plan Accountability Update for the second quarter of 2025. The update covers the latest developments in Medicare…
Headline
The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior…
Headline
The departments of Health and Human Services, Labor, and the Treasury have certified two more independent dispute resolution entities, bringing the total…
Headline
The Centers for Medicare & Medicaid Services April 10 announced that it does not intend to approve new or extend existing requests for federal funds to…