Ira Burnim, legal director of the Bazelon Center for Mental Health Law, which litigates for better mental health treatments, said that while he was not familiar with eating (disorders), “study after study” had shown that (residential) centers for other mental or emotional disorders were not as effective as treatment at home.
Dr Anne E. Becker, president of the Academy of Eating Disorders and director of the eating disorders program at Massachusetts General Hospital, said that despite a (paucity) of studies, “There’s no question that residential treatment is life-saving for some patients.”
Some insurers say that there is no treatment for (physical) illnesses that is equivalent to residential treatment for mental illnesses, and therefore residential treatment does not have to be paid for under parity laws.
Ms. Harlick’s lawyer, Lisa S. Kantor, argued that residential treatment centers were equivalent to skilled (nursing) facilities, which Blue Shield did cover.
Adam Pines, a lawyer for Blue Shield, countered that residential treatment was more akin to assisted living, which the insurer did not cover.
The Ninth Circuit Appeals judges, based in San Francisco, ruled that (residential) treatment was medically necessary for eating disorders, and therefore had to be covered under the state’s parity law, even if no exact equivalent existed on the physical (disease) side.
