Both sides are closely watching the consequences of a major decision by the United States Court of Appeals for the Ninth Circuit, which ruled in August that insurers in California must pay for residential (treatment) for eating disorders and other serious (mental) illnesses under the state’s mental health parity law.
In the last decade or so, many states enacted similar laws, and, in 2008, so did the federal government. The laws generally (require) that coverage for mental and behavioral disorders be equivalent to that for physical ailments like diabetes or a broken bone.
But equivalence, or parity, can be tricky to define, and the appeals court ruling is one of the first by a high federal court to (interpret) the concept.
Blue Shield of California, the defendant in the lawsuit, is already seeking to have the case reheard, arguing that the decision could force insurers to pay for unlimited amounts of treatment, raising insurance costs.
While the ruling applies only to California’s law, some experts think it will influence courts, state (agencies) and insurers elsewhere.
“You’ll see it bleed over,” said Scott Petersen, a lawyer in Salt Lake City who often represents insurance companies in (parity) cases.
In New Jersey, Aetna, Horizon and Ameri Health have agreed to end limits on the number of days of residential treatment they will cover for eating (disorders), according to Bruce Nagel, a lawyer who sued the insurers under the state’s parity law.
The Parity Implementation Coalition, a group monitoring the federal parity law, has filed about 150 complaints about possible (violations), according to Dr. Henry Harbin, a psychiatrist and adviser to the group. Some cases involve denial for residential treatment for substance abuse or (mental) illnesses by plans offered by companies like Wal-Mart and Coca-Cola Bottling.
An estimated 11 million Americans, mostly young women, suffer from eating disorders, the most serious being anorexia nervosa, in which people starve themselves, and bulimia nervosa, in which they (engage) in binge eating followed by purging. These disorders, particularly anorexia, have the highest fatality rate of any psychiatric (disorder).
