Wolters Kluwer Health Plan Must Pay for Teen’s Inpatient Care

Wolters Kluwer United States Inc.‘s health plan must retroactively reinstate residential mental health care benefits its administrator arbitrarily and capriciously denied to a participant’s teen daughter, a federal court said.

The administrator initially approved payments for Campbell Hatch’s stay at Paradigm Treatment Centers in Malibu, Calif., but later reversed its position using the same medical necessity standard, the US District Court for the Northern District of Illinois said Tuesday.

The reversals were arbitrary because the patient’s condition either hadn’t changed or had worsened, the court said in granting summary judgment for Hatch and her mother, Perry.

Campbell, who was ...