Breast Cancer Coverage

Improving Coverage for Breast Cancer Treatment: Schoenburg v. Blue Shield

SCHOENBURG V. BLUE Shield is an excellent example of why the LA Daily Journal says of attorney Michael Bidart, “He has the ability to make public policy with his verdicts.”

Breast cancer has become one of the top health issues in the United States, and because of Bidart’s efforts, women can now receive progressive treatment for it without having to hock all their possessions to pay the bill.

In 1992 Judith Schoenburg and her husband Robert had to borrow against their house in order for Judith, afflicted with metastatic breast cancer, to receive an advanced treatment consisting of a bone marrow transplant in conjunction with high doses of chemotherapy. The treatment, shown to work with leukemia patients, was recommended by Judith’s doctors.

The Schoenburgs were forced to pay for the costly treatment themselves because Blue Shield, which was hired by the California Public Retirement System as healthcare insurance administrator, refused to cover the procedure, calling it “investigational.”

Attorney Michael Bidart brought suit against Blue Shield on behalf of Judith Schoenburg and showed that the company was unreasonably applying a blanket practice of rejecting such treatments without considering their real merit as remedy.

The jury in the case awarded the Schoenburgs $312,000, which allowed the couple to pay back their mortgage loan.

More important, Blue Shield, in order to avoid more lawsuits and larger verdicts, established a breast cancer treatment plan with four medical transplant centers. Patients with Blue Shield who qualify for the treatment now receive full coverage, which can amount to upwards of $150,000.

With the verdict and its strong implications for the insurance industry, Michael Bidart was able to bring about great and needed change in insurance coverage standards for all policyholders in California.