A Florida woman is suing Anthem, alleging that the insurance company didn't cover a spine device that should have been covered under the Employee Retirement Income Security Act, designed to provide protections to as well as setting rules for employer-sponsored health insurance plans.
The plaintiff, Brenda Honeycutt, works for a financial services company based in Alameda County in California. She had a spinal decompression procedure done with the Coflex interlaminar stabilization device to treat spondylolisthesis, according to a lawsuit filed July 29 in the U.S. District Court for the Central District of California.
Ms. Honeycutt, who was covered under an ERISA health plan, received a letter from Anthem on May 11 saying her claim for surgery with the device was denied.
Anthem's letter said the denial was on the basis that the Coflex device was "experimental/investigational," the lawsuit said. The FDA considers Coflex a class 3 medical device, which "usually sustain or support life, are implanted or prevent potential unreasonable risk of illness or injury," according to court documents filed July 27.
Anthem didn't immediately respond to a request for comment Aug. 2.This article will be updated if the insurer responds.