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.
