Chimicles Schwartz Kriner & Donaldson-Smith LLP (CSK&D) has filed four landmark class action lawsuits against insurance carriers for failing to provide, cover, and administer Comprehensive Lactation Benefits to all eligible plan participants and beneficiaries as a no-cost preventive service in accordance with the ACA.
Ferrer et al. v. CareFirst, Inc. et al.
The first complaint was filed on October 28, 2016, in federal court in Washington, DC against CareFirst, Inc. (“CFI”), Group Hospitalization and Medical Services, Inc., d/b/a CareFirst BlueCross BlueShield (“GHMS”), CareFirst of Maryland, Inc., d/b/a CareFirst BlueCross BlueShield (“CFM”), CareFirst BlueCross BlueShield (“CareFirst BCBS”), and, CareFirst BlueChoice, Inc. (“CFBC”) (collectively referred to as “CareFirst” or “Defendants”).
On July 17, 2017, United States District Judge Amit P. Mehta denied Defendants’ Fed. R. Civ. P. 12(b)(1) Motion to Dismiss in Ferrer. Among other things, the Court’s Order holds that the Ferrer complaint “easily establishes standing at the motion to dismiss stage” because: “each [p]laintiff alleges that CareFirst’s denial of full coverage resulted in each [p]laintiff having to pay hundreds of dollars out of pocket for lactation services, thereby easily meeting the injury-in-fact requirement”; and, “[p]laintiffs satisfy the element of causation, because they allege that CareFirst’s refusal to pay the full cost of out-of-network lactation services, when it offers no in-network providers, violated the ACA and gave rise to their economic harm.” See, Order at page 5.