Homestoryhealth insurance › Health Net Accused Of Misrepresenting Its Doctor And Hospital Networks

News Story

Health Net Accused Of Misrepresenting Its Doctor And Hospital Networks

KCBS TV-2 LOS ANGELES, CA
http://losangeles.cbslocal.com/2015/02/03/health-net-accused-of-misrepresenting-its-doctor-and-hospital-networks/

SANTA MONICA (CBSLA.com) — An actress claims Health Net’s “bait and switch” tactics forced her to pay $12,000 out-of-pocket for cancer treatment, an accusation echoed by at least two more women who are part of a class-action lawsuit against the insurance company.

The lawsuit, which was filed late in 2014 and will receive an initial hearing by the Los Angeles Superior Court later this month, accuses Health Net of misrepresenting their physician and hospital networks. According to the advocacy group Consumer Watchdog, Health Net has the fewest doctors available to its enrollees of all the leading insurance companies in California in 2014 and has made further reductions in 2015.

Health Net’s limited hospital and doctor network forced Heather Brianna Womick, an actress, stunt performer and professional dancer, to seek a surgeon outside of Health Net’s network when she was diagnosed with breast cancer in early 2014 and had to undergo a double mastectomy, according to Consumer Watchdog.

Womick said of eight different surgeons on Health Net’s list of “in-network” doctors, six did not accept her health plan, one was on maternity leave, and the last specialized in rhinoplasty, not breast reconstruction. Because of Health Net’s inadequate network, Brianna incurred more than $12,000 in charges for the procedure that should have been available in-network and largely paid for by Health Net, Consumer Watchdog officials said.

“Health Net misrepresented the doctors and providers in its subscriber network – the old bait and switch,” said attorney Travis Corby. “Health Net betrayed its members’ trust, and left its members with huge medical bills.”