Health Net Sued Over Network Adequacy

A lawsuit filed this week in California Superior Court in Los Angeles alleged a seven-week delay in care resulted in permanent harm to a Health Net enrollee. The suit blames a small provider network.

Terry LaRue v. Health Net of California filed Tuesday claims LaRue’s insurance provided by Health Net through Covered California should have delivered immediate care for a hand injury. 

“With knowledge that hundreds of thousands of California consumers would be taking advantage of the Affordable Care Act’s open enrollment period, Health Net actively marketed its new health plans and ability to provide accessible care,” said the lawsuit’s lead attorney, Robert Gianelli of Gianelli and Morris, based in Los Angeles.

“In its rush to capture market share and maximize profit,” Gianelli said, “the defendants deliberately broke their promises by taking shortcuts in ensuring the networks were properly established.”

Health Net officials did not comment on the suit specifically.

“Health Net strives to provide members with access to quality care and help them navigate the health care system,” said Brad Kieffer, director of communications at Health Net.

Calls to a co-defendant named in the lawsuit, Accountable Health Care IPA based in Signal Hill near Long Beach, were not immediately returned.

Class action lawsuits have been filed against other insurance companies over alleged network inadequacy but those were not based on actual harm, Gianelli said.

“This is the first case I’m aware of where someone was deprived of treatment with serious consequences [due to network inadequacy],” Gianelli said.

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