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Anthem BCBS Faces Lawsuit Over Alleged Illegal Capping of Eating Disorder Coverage

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Anthem Blue Cross Blue Shield Faces Lawsuit

Eating disorders such as anorexia or bulimia are serious mental health problems.  Anthem Blue Cross Blue Shield seems to think otherwise and is facing a class action lawsuit that accuses the insurer of violating California law which requires coverage of recommended care for PPO policy holders diagnosed with an eating disorder.  The lawsuit was filed on August 19 in Los Angeles Superior Court and alleges that the insurer has refused to pay for the recommended treatments for eating disorders for afflicted patients.

California Law Protects Those With Eating Disorders

California is one of few states that has a law protecting those suffering from serious mental health problems.  The California Mental Health Parity Act protects those with severe mental illness and states that these patients are entitled to the same care that people suffering from a physical illness do.  Shelby Oppel, 24, is the lawsuit’s named plaintiff and alleges that Anthem BCBS rejected her claims for treatment for bulimia nervosa, an eating disorder characterized by binge eating followed by laxative use or vomiting to rid the body of the food.  Bulimia is one of the eating disorders classified as a severe mental illness according to the California Mental Health Parity Act.

Lawsuit Alleges that Anthem BCBS Relies on Outdated Guidelines for Treating Eating Disordered Patients

According to the lawsuit, Anthem BCBS relies on outdated psychiatric guidelines for treating eating disorders to save the company money.  It also accuses the company of interfering with doctors’ judgement and for discriminating against those with eating disorders.  Anthem spokesman, Darrel Ng, recently stated that although the insurer could not comment on the allegations specifically, its mental health protocols are lawful and appropriate.  The lawsuit seeks $4,000 per patient who was a PPO policy holder denied full treatment from Anthem for an eating disorder since 2009.

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    […] Anthem BCBS Faces Law Suit Over Illegal Capping of Eating Disorder Coverage – Did you read yesterday’s post? GET ANGRY people. This is so terrible. […]