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Jury says Anthem must pay for out-of-state operation

By Richard Binder

Last month Ephraim Nehme sued Anthem Blue Cross to pay for an out-of-state liver transplant after the insurance giant refused. Blue Cross originally approved for the transplant to take place at UCLA, where Nehme's doctor strongly recommended that the patient have the operation in Indiana, where wait times were much shorter.

Yesterday a jury concluded that Anthem should cover not only the cost of that operation in Indiana, but Nehme's legal costs as well.

At a hearing set for next week, Scott Glovsky, Nehme's lawyer, said he will ask Superior Court Judge Kenneth Freeman to order Blue Cross to allow its California members to pursue organ transplants at hospitals nationwide that do business with its parent, Indianapolis-based WellPoint Inc.

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Full post as published by Legal Pad | LA on March 16, 2010 (boomark / email).