Kaiser and DMHC Face Lawsuit for Discriminatory Failure to Cover Wheelchairs
Health insurance plans administered by Kaiser Foundation Health Plan, and endorsed by the California Department of Managed Health Care (“DMHC”), do not provide effective coverage of wheelchairs needed by people with disabilities. Kaiser plans either completely exclude coverage of, or impose a $2,000 cap on coverage of, wheelchairs (which can cost up to $50,000 out-of-pocket). This class action lawsuit, which represents the interests of disabled people who need wheelchairs to remain mobile, stay healthy, commute to work, and participate fully in community life, challenges these exclusions and limitations as discriminatory and a violation of the Affordable Care Act’s “essential health benefit” guarantees.
The plaintiffs are represented by the Disability Rights Education and Defense Fund and Rosen Bien Galvan & Grunfeld LLP. They seek injunctive relief to eliminate these discriminatory policies.
Update
DREDF and its co-counsel Rosen, Bien, Galvan & Grunfeld won an arbitration award in favor of Claimant Beth Smith related to ongoing litigation challenging California and Kaiser’s failure to ensure coverage for medically necessary wheelchairs in Affordable Care Act (ACA) plans. Under the arbitration award, Kaiser must pay for Ms. Smith’s medically necessary wheelchair every five years, as well as for repair and maintenance costs when necessary. Please contact info@dredf.org if you are insured by a small-group or individual ACA plan and need a medically necessary wheelchair.
Update
The Los Angeles Times covers the case: Years after lawsuit, Kaiser will pay for new wheelchair for California woman