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Durham native and former Wake Forest University star Rodney Rogers has filed a lawsuit against Blue Cross and Blue Shield of North Carolina, accusing the insurer of wrongly denying coverage for in-home nursing care, putting his life at risk.
Rogers was born in Durham and starred at Hillside High School before going on to play at Wake Forest from 1990 to 1993. He was conference rookie of year as a freshman, beating out Duke's Grant Hill, and named ACC Player of the Year and second team All-American as a senior in 1993. For his career at WFU, he averaged 19.3 points and 7.9 rebounds per game, and his No. 54 was retired in February 1996 by Wake Forest.
Nicknamed the Durham Bull, Rogers was the ninth pick in the 1993 NBA Draft and had a 12-year career in the league that included stints with the Los Angeles Lakers, Boston Celtics and Philadelphia 76ers. Rogers was NBA Sixth Man of the Year in 2000.
But a dirt bike accident in Vance County in 2008 rendered him paralyzed from the neck down.
The lawsuit against Blue Cross NC claims Rogers, 52, has been insured by the Durham company since 2014, yet only recently did the company decline coverage for in-home nursing services. That’s as Rogers’ condition, according to the complaint, has only gotten worse.
“This lapse in coverage has placed an enormous physical and emotional strain on my wife, who is not a specialized health care provider, and on me,” Rogers said in a press release about the lawsuit. “This denial of coverage is particularly frustrating since I have already had to confront the harsh reality of once being a professional athlete and then becoming a ventilator-dependent quadriplegic, and now I’m facing the possibility of even more dire health issues because of BCBSNC’s healthcare denial.”
Blue Cross NC did not immediately return a request to comment Tuesday. Nor did the company's attorney, Chase Stevens of Kilpatrick Townsend & Stockton. Blue Cross NC recently asked for more time to respond to the lawsuit in court.
The lawsuit was filed in Durham County in February and transferred to U.S. District this month.
Rogers’ attorney, Mac Sasser, partner at Sasser Law, said it is “rather astonishing that Blue Cross Blue Shield of North Carolina would suddenly deny the very care they’d always provided when there was no improvement in his health.”
“Without the in-home nursing care that’s been provided to him for years … Mr. Rogers could die from a complication of his illness or a malfunction of his medical equipment,” Sasser said.
Rogers has been dependent on “life-sustaining medical equipment,” including a ventilator and a gastric tube, since 2008, according to the lawsuit. Since that time, Rogers has required specialized and in-home care, requiring “close surveillance for his life sustaining and corrective medical care.” And through 2022, Blue Cross NC had approved and paid for the nursing care Rogers received at home.
But that changed in December 2022, when his medical providers sought recertification to continue providing in-home nursing care.
According to the lawsuit, Blue Cross NC denied the coverage, alleging that nursing care “does not meet the definition of Medical Necessity found in the member’s benefit booklet.”
The denial alleged Rogers’ condition was “stable” and did not require a skilled nurse, something Rogers’ attorneys dispute in the lawsuit.
The complaint claims Blue Cross NC made the decision without citing any change or improvement in Rogers’ medical condition that would indicate nursing care is no longer needed.
Rogers provided multiple letters from medical providers confirming in-home care was necessary. One letter cited in the lawsuit, from Dr. Alexander Pean, describes Rogers as “very frail with multiple complex respiratory and infectious needs … require[ing] wound dressing changes, attentiveness to his feeding schedule, respiratory needs, and he has a history of recurrent infections sometimes resulting in sepsis.”
Another letter, from Dr. Brock Bowman, says that not only has Rogers’ care not stabilized, it has “become more medical.”
But despite those letters, Blue Cross NC continues to deny the claim, even after Rogers was admitted to the intensive care unit at Duke University Hospital in 2023 for septic shock and other conditions.
Blue Cross NC's "decisions to deny Mr. Rogers’s continuing claims were and are born of pecuniary, corporate self-interest,” the lawsuit says.
Rogers is represented by an attorney group that includes Charles Sasser and Rachel Matesic at The Sasser Law Firm and Theodore Leopold and Rachael Flanagan of Cohen Milstein.