Harvard Pilgrim Not Liable for Covering $800-Per-Day Care

Harvard Pilgrim Health Care Inc. doesn’t have to pay for four months of treatment a college student with psychotic disorder received at an out-of-network residential treatment facility, a federal judge ruled (Doe v. Harvard Pilgrim Health Care, Inc., 2017 BL 363962, D. Mass., No. 1:15-cv-10672, order granting summary judgment to defendant 10/11/17).

Harvard Pilgrim acted reasonably in concluding that the student—who experienced auditory hallucinations and suicidal thoughts—could have been treated in an outpatient setting while living at home, the judge ruled Oct. 11. The student failed to show that her mental health would have been in a worse ...