Anthem Gets Nod for $12.9 Million Deal Over Mental Health Rules

Anthem Inc. received initial approval for a $12.9 million settlement resolving a class action claiming it wrongly refused to cover mental health and substance abuse treatments by using overly restrictive criteria for gauging medical necessity.

The agreement is slated to benefit nearly 19,000 people whose coverage requests were denied using the challenged guidelines. Patients who paid out-of-pocket for their treatments can submit claims for reimbursement, and all other class members will receive nominal payments of at least $100 each without having to file a claim, according to court filings with the US District Court for the Eastern District of New ...