Blue Shield of California told reporters investigating the death of San Francisco firefighter Ken Jones that it was legally barred from discussing his cancer case. Federal health officials say that claim was wrong.

The discrepancy — confirmed by the U.S. Department of Health and Human Services — is the latest in a series of accountability failures surrounding Jones's care that have become a flashpoint for Bay Area insurance reform advocates. Jones, a veteran SF firefighter who died of Stage 4 lung cancer in May after Blue Shield denied him immunotherapy, is now at the center of a story that raises questions not just about one claim, but about whether the state's largest nonprofit insurer is using legal procedure as a shield against scrutiny.

Blue Shield of California told reporters investigating the death of San Francisco firefighter Ken Jones that it was legally barred from discussing his cancer case. Federal health officials say that claim was wrong.

The U.S. Department of Health and Human Services — the same agency Blue Shield cited to justify its silence — told NBC Bay Area's investigative team that patient privacy authorizations do not automatically expire when a patient dies. Jones, who died of Stage 4 lung cancer in May, had signed a HIPAA authorization form in January giving NBC Bay Area access to his insurance records. The form carried a one-year expiration date, meaning it remained legally in force at the time Blue Shield declined to speak.

"If an authorization is in effect at the time of the individual's death … the authorization remains valid," an HHS spokesperson told NBC Bay Area.

Blue Shield did not address that discrepancy when NBC Bay Area raised it. A company spokesperson had written that "according to Health and Human Services, when a patient passes away, any signed HIPAA authorization form giving permission to discuss that patient's [protected health information] becomes legally null/void" — a characterization HHS directly contradicted. The company did not respond to a follow-up.

That HIPAA claim came after months of Blue Shield stonewalling on a more fundamental question: why did Jones's oncologist, Dr. Matthew Gubens of UCSF's Thoracic Medical Oncology Clinic, spend more than three hours on hold before abandoning a phone appeal of Jones's denied coverage?

Gubens had been calling the number printed on Blue Shield's own denial letter.

"I reached people who apologized, but they weren't the right place to send the appeal to, and often referred me back to the first person I talked to," Gubens told NBC Bay Area, which first broke the story in February. "That number goes through a phone tree that eventually hangs up on me."

After more than four months of no response to that question, Blue Shield finally offered an explanation this week: the appeals number on its denial letters was designed for patients, not physicians, and a "routing" glitch sent Gubens in circles. The insurer says it has since retrained its call center operators.

But the explanation skirts the harder question. What Gubens could not convey over the phone, he eventually put in writing — and Blue Shield denied that written appeal too. Jones died without receiving the immunotherapy his oncologist had prescribed to bolster his immune response against the cancer, while the chemotherapy Blue Shield did approve proceeded alone.

Blue Shield Senior Vice President of Commercial Markets Tim Lieb declined to address the Jones case specifics when NBC Bay Area encountered him at San Francisco City Hall earlier this month. Lieb was attending a closed-door meeting with firefighter advocates pressing the insurer for operational reforms. "We cannot talk about any of the member-specific issues — that's not something we're able to do," he said. "There's questions, but we can't respond to them."

Blue Shield insures nearly 6 million Californians — roughly 15 percent of the state's population — and operates as a nonprofit. Whether it will ever address the merits of the coverage denial that Jones and his doctors spent his final months fighting remains, for now, an open question.

Original investigation by Bigad Shaban and Jeremy Carroll at NBC Bay Area.