Report: Insurer Sued Over Narrow O-Care Networks

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Anthem Blue Cross is now facing multiple lawsuits over the narrow physician networks it used in plans on California's ObamaCare exchange, according to a report.

A new lawsuit filed Tuesday in state court alleges that the insurance giant misled consumers into buying plans with narrow networks when they believed they were receiving more robust coverage.

The action follows two similar lawsuits filed in May and June over the exclusive provider organization (EPO) plans, which typically offer little to no coverage for out-of-network doctors.

Plaintiffs say they believed they were buying more generous preferred provider organization (PPO) plans.

In at least one case, a consumer said she was sent an insurance card mistakenly describing her coverage as PPO, leaving her on the hook for several thousand dollars worth of medical coverage.

The issue strikes at the heart of a major criticism of plans on ObamaCare's exchanges.

Consumer advocates argue that insurers are unnecessarily limiting the number of doctors they cover in order to preserve profits. Critics of ObamaCare say the narrow networks are the result of the law's many new rules for insurers.

Narrowing provider networks typically helps carriers hold down premiums and enhance plans' attractiveness as consumers comparison shop by price.

In response to lawsuits, Anthem said that materials available to consumers clearly stated the coverage limitations of EPO plans.

The company also said that it has cleared up confusion surrounding cards that stated "PPO."

The latest lawsuit was reported late Wednesday by the Los Angeles Times. 

 

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