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San Francisco Leaders Press Blue Shield Over Retired Firefighter’s Cancer Coverage

City Hall scrutiny intensified following Blue Shield’s approval of chemotherapy without the UCSF oncologist’s recommended immunotherapy.

Overview

  • Ken Jones’ family says Blue Shield initially denied his UCSF-prescribed regimen, then on Jan. 9 approved a modified plan that excludes immunotherapy.
  • Jones’ wife reports the authorization delays coincided with a decline in his condition, and he is now receiving chemotherapy under the revised approval.
  • Mayor Daniel Lurie joined Supervisors Connie Chan and Matt Dorsey at a City Hall rally to demand answers from Blue Shield and support Jones’ care.
  • Dorsey and Chan cited at least three other retired firefighters whose cancer treatments were initially denied or delayed, with two later approved after intense advocacy.
  • The city’s 2024 switch to a Blue Shield Medicare Advantage plan covers roughly 5,000 people, and officials are gathering denial reports as Blue Shield says coverage follows CMS policies and members can appeal.