Anthem Settles Mental Health Coverage Row for Nearly $13 Million

Anthem Inc. will pay about $12.9 million to resolve a class action saying it wrongly refused to cover mental health and substance abuse treatments using overly restrictive criteria for gauging medical necessity.

The agreement would benefit nearly 19,000 people whose coverage requests were denied using the challenged guidelines, the plaintiffs said Monday in a motion seeking approval for the deal. Patients who paid out-of-pocket for their treatments can submit claims for reimbursement, and all other class members will receive nominal payments of at least $100 each without having to file a claim, they told Magistrate Judge Steven I. Locke of ...