Case: Health & Welfare Benefits/Mental Health (D. Utah)

Anthem Blue Cross & Blue Shield is entitled to summary judgment in an ERISA lawsuit seeking $176,000 to cover a minor’s 17-month stay at a residential mental health treatment facility in Utah, according to a ruling by a federal judge in that state. Anthem correctly determined that the patient’s discussion of and engagement in self-harming behavior didn’t “rise to the level of a serious risk of harm,” the court said, agreeing that the treatment wasn’t medically necessary under the terms of the relevant health plan. The court also rejected a claim that Anthem violated the federal mental health parity law, ...