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Medical Standards Case Against Anthem Survives Dismissal


Health
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March 8, 2021
On Friday the court issued an order denying the motion to dismiss in a case brought against Anthem BlueCross BlueShield of Wisconsin et al. The case, filed in the District of Utah, alleges that Anthem BlueCross BlueShield, in administrating the Advocate Aurora Health Care, Inc. Health and Welfare Plan was unfairly requiring higher medical standards for mental health treatment than for medical treatment in violation of the Parity Act, a subset of ERISA.
The plaintiff’s son was admitted to two separate residential treatment facilities after outpatient treatment was not successful. BCBS denied the treatment as not medically necessary, stating that lower levels of care, such as an intensive outpatient program (“IOP”) or a partial hospitalization program (“PHP”), should have been tried prior to moving to a residential setting. BCBS also indicated that there was no evidence of imminent harm to justify skipping these lower leve ....

United States , Gross Rooney , Brians King , Jones Waldo Holbrook Mcdonough , Bluecross Blueshield , Aurora Health Care Inc , Anthem Bluecross Blueshield , Advocate Aurora Health Care , Welfare Plan , Parity Act , Jones Waldo Holbrook , ஒன்றுபட்டது மாநிலங்களில் , மொத்த ரூனி , பிரையன்ஸ் கிங் , ஜோன்ஸ் வால்டோ ஹோல்ப்ரூக் மக்டந , ப்ளூ கிராஸ் ப்ளூஷீல்ட் , அரோரா ஆரோக்கியம் பராமரிப்பு இன்க் , கீதம் ப்ளூ கிராஸ் ப்ளூஷீல்ட் , வழக்கறிஞர் அரோரா ஆரோக்கியம் பராமரிப்பு , நலன்புரி திட்டம் , சமநிலை நாடகம் , ஜோன்ஸ் வால்டோ ஹோல்ப்ரூக் ,