Anthem Ordered to Rethink Child’s Mental Health Coverage Denial

Anthem Blue Cross & Blue Shield must reconsider its refusal to cover a 13-year-old boy’s stay at a residential mental health treatment center, but it’s free from claims under a federal mental health parity law.

Anthem “shut its eyes” to the opinions of the child’s treating clinicians, selectively reviewed his medical records, and failed to adequately explain why it denied further payments after covering the child’s first three weeks at Utah’s Elevations Residential Treatment Center, the US Court of Appeals for the Sixth Circuit said Thursday. The court ordered Anthem to reconsider its coverage decision, reversing an opinion ruling against ...