SAN FRANCISCO (KGO) — ABC7 is following the story after a retired San Francisco firefighter had his cancer treatment denied by Blue Shield.
We’re now learning he is not the only city firefighter whose cancer treatments have been denied by the same insurance company.
On the steps of San Francisco City Hall on Friday, current and retired firefighters joined forces to fight for one of their own: retired firefighter Ken Jones.
“This is unacceptable. Firefighters in California have a legal presumption that cancer is job-related. We earned that presumption through decades of exposure to toxic smoke, burning chemicals and carcinogens — all contracted in the line of duty. Firefighter Jones upheld his end of the bargain. He served our city. He served our members. He paid into the system,” said Sam Gebler, president of IAFF Local 798.
A week ago, Jones sat in the back of the City and County of San Francisco’s Health Service Board with his family, asking the board to intervene after his treatment for stage 4 lung cancer was denied by Blue Shield, the city-provided insurer.
PREVIOUS STORY: City asked to intervene after SF firefighter’s stage 4 lung cancer treatment denied by Blue Shield
“After we got some publicity, thank you, a Blue Shield physician reached out to Ken’s physician, and they worked out a different plan that Blue Shield would cover. It’s still an incomplete plan,” said Helen Horvath, Jones’ wife.
Since then, Jones’ story has led to an investigation into other cases, with the city’s mayor vowing to support firefighters.
“You all always have our back, and we’re always going to have your back, especially when it comes to your health care,” said Mayor Daniel Lurie. “We will get to the bottom of this.”
According to San Francisco’s Health Service Board, about 5,000 city employees and retirees are insured by Blue Shield. Now, city leaders are asking anyone who has been denied cancer treatment to speak up.
“We’ve heard of three other retired firefighters that are being denied cancer treatment by Blue Shield,” said Dean Crispen, Chief of the SF Fire Department.
MORE: COVID patient recruited to participate in ‘free’ research study, gets hit with $6.9K bills
Tony Stefani with the Cancer Prevention Foundation said firefighters with a cancer diagnosis have a 14% higher chance of dying than other cancer patients in the general population.
“Current statistics tell us that 65% of the men and women in our profession are going to contract some form of cancer in their lifetime. Some of them will be fatal,” Stefani said.
In a Statement Blue Shield said, in part: “For Medicare members, health plans must follow medical policy established by the Centers for Medicare and Medicaid Services (CMS).”
San Francisco Supervisors Matt Dorsey and Connie Chan sent a letter to the San Francisco Health Service System concerning Blue Shield’s decision.
MORE: A 15-min, $100K trip to ER left Antioch family with burned infant in billing mess: ‘Unbelievable!’
“We will utilize every possible tool in our toolbox to go after you. And we’re putting you on notice right now,” Chan said.
Dorsey is a commissioner on the board that approved the switch for city workers from United Healthcare to Blue Shield last year. He said many are regretting it.
Luz Pena: “What can the board do?”
“What the board could do is, we would actually probably go to our city attorney and take a look at the agreement and see if there is some breach of the agreement,” Dorsey said.
Blue Shield’s full statement:
Our hearts go out to individuals and their families who are facing a cancer diagnosis or navigating treatment.
We are committed to supporting our members with compassion and working with their doctors to help them access care and resources.
For Medicare members, health plans must follow medical policy established by the Centers for Medicare and Medicaid Services (CMS). Our goal is to ensure members receive safe and effective care covered by Medicare.”
Blue Shield sent the information below to explain how “Medicare works and what steps health plans must follow.”
Medical policy established by the Centers for Medicare and Medicaid Services (CMS). Health plans are legally required to follow the CMS criteria.
All applicable state and federal regulatory requirements, such as those set by the Food and Drug Administration (FDA) for prescriptions and treatments.
Evidence-based guidelines from organizations such as the National Comprehensive Cancer Network, which is a not-for-profit alliance of leading academic cancer centers.
Review by a qualified clinician to confirm the treatment is safe, effective and meets medical standards.
If the above criteria cannot be met, we work with our members and their providers with a goal of giving patients access to safe, quality care, that is FDA-approved or an off-label treatment if it’s allowed under Medicare program requirements.
Medicare members can file appeals directly with health plans. They are also entitled to an immediate, independent review by a qualified independent review organization designated by and contracted with CMS.
If the independent review entity disagrees with the plan’s determination, the plan must cover the service. If, however, CMS’ independent review entity determines that the service is not clinically supported and covered under Medicare, the plan is also bound by that determination. Members and providers are informed of additional appeal rights through the CMS Medicare program at that time.”
Copyright © 2026 KGO-TV. All Rights Reserved.