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AvMed Must Face Family’s Wilderness Therapy Coverage Suit

Feb. 21, 2020, 5:06 PM

A Florida family is advancing a lawsuit accusing health insurer AvMed Inc. of wrongly refusing to pay for their teenage son’s treatments at a wilderness therapy program and a therapeutic boarding school, under a decision by the District of Utah.

Judge Dee Benson declined to dismiss the family’s claim for wrongfully denied benefits under the Employee Retirement Income Security Act, concluding that they adequately alleged that the treatments were medically necessary and that AvMed didn’t follow the statute’s claims processing requirements.

But Benson dismissed their claims under the Mental Health Parity and Addiction Equity Act, the federal law that requires...

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