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Ex-NBA Player Sues BCBS Over ‘Outrageous’ Care Denial

Law360

April 8, 2024

Former NBA player Rodney Rogers, who was paralyzed in 2008 after retiring, has accused Blue Cross and Blue Shield of North Carolina of exhibiting “outrageous” disregard for his medical needs by denying him life-saving in-home nursing assistance.

In a complaint that hit a North Carolina federal court Friday, Rogers accused Blue Cross of cutting off care despite authorizing similar coverage for nine years while the insurer ignored doctors’ recommendations and baselessly claimed his condition was “stable.”

Blue Cross’ “denials of care for Mr. Rogers are not based upon qualified medical opinion and sound medical evidence, but rather on its own, self-serving pecuniary interests and its self-authored ‘Corporate Medical Policies,'” the complaint said, adding the denial of in-home nurses was “outrageous,” “malicious” and “carried out with intentional or reckless disregard for Mr. Rogers medical needs, well-being, rights and safety.”

Rogers signed up for coverage with Blue Cross in 2014, six years after becoming paralyzed in all his limbs and dependent on breathing and feeding tubes, according to his complaint. From that year to December 2022 the insurer had covered skilled nurses to be present at his home to take care of complicated medical needs that if not readily addressed would result in his death.

After surgery for a perforated stomach and developing septic arthritis in his hip in late 2022, as well as applying for precertification of in-home nurses, Blue Cross denied him coverage for skilled nurses at his house, saying that Rogers condition was “‘stable'” and that his “‘care does not require a skilled nurse, and can be provided by a trained family member or caregiver,'” the complaint alleged.

With the denial, Blue Cross ignored the recommendations of six Duke University Hospital doctors, one of whom said Rogers “‘care warrant[s] skilled nursing to the maximum extent possible,'” according to the lawsuit.

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Rogers is represented by Charles Sasser and Rachel C. Matesic of The Sasser Law Firm and Theodore J. Leopold and Rachael Flanagan of Cohen Milstein Sellers & Toll PLLC.

Read Ex-NBA Player Sues BCBS Over ‘Outrageous’ Care Denial.