Anthem Blue Cross Life & Health Insurance Co. again beat a proposed class action accusing it of systematically denying coverage for continued residential treatment for eating disorders.
Aurora Bailey, the 22-year-old woman who filed the lawsuit, is no longer a covered beneficiary under the plan and therefore can’t seek to represent a class of members for prospective injunctive relief, Judge Jeffrey S. White held in a decision filed Dec. 5.
The decision comes almost seven months after White dismissed Bailey’soriginal lawsuit, holding that she didn’t have standing to sue Anthem Blue Cross and that her allegations weren’t clear on the potential for relapse or ongoing treatment of her mental disease and eating disorder.
White’s latest opinion is noteworthy because he accepted Bailey’s argument that she suffers a real and immediate threat of future harm. Bailey was able to show this by citing a study that she said indicates the prevalence of relapse for patients with anorexia nervosa.
Approximately 20 million women and 10 million men in the U.S. will have an eating disorder at some point in their lives, according to data from the National Eating Disorder Association.
“Relapse after treatment for anorexia nervosa is a significant clinical problem,” Bailey’s lawsuit said. Studies show that the time with the greatest risk for relapse is the first year post-treatment for at least up to 17 months after being “well,” according to the lawsuit.
The information that Bailey was no longer a covered beneficiary was provided by Anthem in the course of briefing the motion to dismiss. White granted Bailey leave to amend her lawsuit to assert whether she is still covered by the plan or to plead only retrospective injunctive relief as a former member of the plan.
Kantor & Kantor LLP and Kathryn M. Trepinski represent the participant. Morgan Lewis & Bockius LLP represents Anthem.
The case is Bailey v. Anthem Blue Cross Life & Health Ins. Co. , N.D. Cal., No. 4:16-cv-04439-JSW, order granting defendant’s motion to dismiss 12/5/17 .
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