Joseph Romano Law

A patient with breast cancer and her treating doctor wanted her health insurer to pay for a PET scan (positron emission tomography). The health insurer would only pay for CT scans (computerized tomography), mammography, and ultrasounds. Neither of the approved scans diagnosed her cancer in a timely manner. Her cancer metastasized.

Several studies show a better rate of success for PET scans in the detection of lung, breast, and colon cancers compared to other imaging systems, such as computerized tomography (CT) scans or mammograms. In light of the new studies demonstrating the effectiveness of PET scans, insurers who fail to pay for PET scans in the future may be at risk for a bad faith lawsuit.