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June 12, 2014 at 12:16 PM
Courts and insurance regulators in two big states — California and New York — are moving toward requiring health insurers to pay for more residential mental health care.
In California, a three-judge panel at an appeals court in Los Angeles earlier this week ruled in favor of Marissa Rea and other people with anorexia nervosa who have been trying to persuade Blue Shield of California to pay for residential care.
The plaintiffs argued that a state mental parity act, the California Mental Health Parity Act of 1999, requires a health insurer to cover “medically necessary treatment” for mental illnesses. Because there is no treatment analog in the realm of treatment for anorexia care in the realm of treatments for physical illnesses, plans and courts must read the state parity act broadly, the plaintiffs said.
Blue Shield of California — which has no connection with the state’s Blue Cross carrier — said California law requires a carrier to provide “basic health services” for both physical conditions and mental health problems, and that state law does not require an insurer to cover all medically necessary treatments for mental illness.
The California court said state lawmakers meant the parity act to be read broadly, not narrowly.
