Question:
To persons denied surgery by Blue Cross Blue Shield of Texas.

Information for the AMOS members.. I was asked by the person below to post this at AMOS.. She posted it on my egroup and she got it from the Fobi egroup.. If you have been denied through BC/BC of Texas, it's worth <b>checking out</b> to see if you have a claim to be added to the class action in the State of Texas. <p> From: <[email protected]> Date: Thu Nov 16, 2000 7:24pm Subject: hey anybody have BC/BS of TX? <p> Hi folks: <p> This is an important message for persons denied surgery by Blue Cross Blue Shield of Texas. Our office has recently filed litigation against that company in conjunction with local counsel for their bad faith denial of bariatric surgery. We are soon going to be seeking to have this case certified as a class action in the State of Texas. IF YOU WERE DENIED SURGERY BY THAT COMPANY WITHIN THE LAST TWO YEARS I hope you will reply to this email and give me information which will allow me to contact you and give you details. If you know someone who fits that description I hope you get them this email. I would appreciate it if any of you with ongoing appointments with your Texas surgeons would print out this email and give it to them (although I am writing to all of them personally too - but your help will be appreciated.) This is the first case of its kind and I am excited we could make some widespread changes (or alternatively fall flat on our faces - but hell - you gotta take risks!) with this case and use it as a springboard to change all over the country. As always, thanks for your help. Walter Lindstrom, Esquire Kelley Brown Lindstrom, Esquire Obesity Law & Advocacy Center www.obesitylaw.com 2939 Alta View Drive - Suite O-360 San Diego, CA 92139 Tel: (619) 656-5251 Fax: (619) 656-5254    — Victoria B. (posted on November 17, 2000)

October 11, 2002
I was denied on Nov.22,2001. I am at my wit's end on this one. Any help will be greatly appreciated. My email address is [email protected]
   — Dymone

December 9, 2002
I just called the Lindstrom # listed in the above reply. I asked them about the class action law suit and asked if they had anyone reply to this e-mail since 2001. She said that they were actually trying to get some people to apply with them and to try and build a class action law suit against BCBSofTX "do not quote me I've slept since then". However they had a case here in TX that went to trial and that it did not pass. It went before a federal jury I beleive that's what she stated, in any case it was futile. It seems in TX that BCBSofTX is adamant about their exclusion for WLS and they won't budge. In other words if you have BCBSofTX even the CHOICE PLAN and it has an EXCLUSION that states that it does not cover WEIGHT LOSS SURGERY and you want to appeal it go ahead and appeal away and it won't do any good what so ever they will not pay for it. The case manager that I spoke to with BCBSofTX that is my husbands provider said that she would walk me through this and see that my paperwork is forwarded from her office and that she would personally get them to stay on top of the appeal. However she was kind enough to remind me that they will rarely overturn a case like this and that they would not consider any of the arguments of co-morbidities I gave her such as GERD,HYPERTENSION,DEGENERATIVE DISC DESEASE,ARTHRITIS. All I can say is it just hasn't happened in TX YET! The attorney's office did have some really great ideas that will take a lot of time and hard work and if your willing I want to hear from you. We can contact our STATE REPRESENATIVE and possibly have this over turn. I Don't beleive this should be the end of this for anyone who is morbidly obese.
   — Denise P.