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

Sept. 14, 2021, 1:00 AM

Health Net Life Insurance Company and Health Net of Arizona, Inc.'s denial of coverage for residential mental health treatment at Uinta Academy in Utah wasn’t arbitrary and capricious, a Utah federal court held. The arbitrary and capricious standard is lenient, and Health Net based its determination on substantial evidence and provided a reasoned basis for denial, the court said. Four psychiatrists reviewed the record and each independently concluded that the treatment wasn’t medically necessary at the time in question, the court said. Treatment for the teenage plan beneficiary was approved for approximately five months, but she remained in the facility ...

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