California Blues sued for denying reconstructive surgery

Blue Shield of California won't pay for reconstructive surgeries to return disfigured patients to normal appearances, which violates state law, a lawsuit against the insurer claims. Lisa Burton sought breast and eyelid surgeries for unspecific reasons, but Blue Shield denied her claims for coverage, reported Courthouse News Service. "Blue Shield has engaged in a pattern and practice of denying requests for reconstructive surgery on the basis they are not 'medically necessary,'" the lawsuit states. Although state law requires insurers cover such surgeries when they create a normal appearance for the patient, Burton alleges Blue Shield "has refused to consider whether the statute's alternative 'normal appearance' test has been met." She added that Blue Shield's decisions weren't made by a reconstructive surgeon, a practice that also violates the state law. Article