Litigation Over the Failure of Insurers to Cover Services for Hearing Loss
July 14, 2020 litigation update: The Ninth Circuit Court of Appeals holds that the Affordable Care Act imposes on health insurers an “affirmative obligation not to discriminate in the provision of health care—in particular, to consider the needs of disabled people and not design plan benefits in ways that discriminate against them.” Please read the press release here. The decision appears here.
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On October 30, 2017, Sirianni Youtz Spoonemore Hamburger filed two lawsuits in federal district court in Seattle, Washington, alleging that Regence Blueshield and Kaiser Foundation Health Plan discriminate on the basis of disability when they design and offer health insurance that excludes nearly all coverage for hearing loss, a federally-recognized and protected disability. Both Regence and Kaiser offer health insurance coverage in Washington state that excludes all coverage for the treatment of hearing loss, including coverage of outpatient office visits with an audiologist, and durable medical equipment, such as hearing aids, except for cochlear implants.
The lawsuits seek injunctive and declaratory relief that would require the health insurers to remove the discriminatory exclusion from their health coverage going forward, and damages that result from Kaiser and Regence’s discrimination. The lawsuits allege that the Affordable Care Act’s non-discrimination provision, Section 1557, found at 42 U.S.C. § 18116 applies disability discrimination protections to certain covered health care entities like Regence and Kaiser.
The media release is attached here.
The Kaiser Complaint may be viewed here. The Regence Blueshield Complaint may be viewed here.
In 2005, the Washington Department of Health conducted a Sunrise Review of the costs and benefits involved with mandating coverage of treatment for hearing loss, which may be viewed here.
For more information, please contact Ele Hamburger at: ehamburger@sylaw.com