Blue Shield Faces Reform Push After 2 Denials in Firefighter's Stage 4 Cancer Case
Updated
Updated · SFist · Jun 7
Blue Shield Faces Reform Push After 2 Denials in Firefighter's Stage 4 Cancer Case
3 articles · Updated · SFist · Jun 7
Summary
Ken Jones, a retired San Francisco firefighter, died Saturday after a four-month fight to obtain lung-cancer treatment his oncologist said Blue Shield denied twice.
Dr. Matthew Gubens said the approval delays cost Jones critical time, with tumors growing, pain worsening and his appetite declining while coverage was disputed.
Jeanine Nicholson, the former San Francisco fire chief and a longtime friend, said Blue Shield "expedited" Jones' death, intensifying pressure on the insurer and city officials.
Blue Shield said last month it would assign dedicated care managers for complex claims, while watchdog group Protect Our Benefits plans to meet the insurer to press for further reforms.
Jones' case has become a broader test of health coverage for roughly 5,000 San Francisco employees and retirees insured through Blue Shield.