Health plan to pay anorexic woman's care

2013-03-04 20:04
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Washington - A health insurance plan must pay for an anorexic woman's residential treatment under a court ruling that remains intact after the US Supreme Court refused on Monday to consider the insurance plan's appeal.

Blue Shield of California originally denied Jeanene Harlick's claim after she sought treatment at a Missouri centre that focuses solely on eating disorders.

The San Francisco-based 9th US Circuit Court of Appeals held in a June 2012 ruling that a state law, the California Mental Health Parity Act, required Blue Shield to pay.

The law states that coverage must be provided for treatment of severe mental illnesses.

The court also held that Blue Shield had waived the opportunity to investigate whether Harlick's treatment was medically necessary.

Blue Shield provided for the first 11 days of treatment but declined to pay any more on the basis that her plan did not cover residential care.

At the time she entered the residential facility, Harlick was 65% of her ideal body weight.

The case is California Physicians Service vs Harlick, US Supreme Court.

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