A recent case out of California has caught the attention of many mental health advocates. Harlick v. Blue Shield of California is the name of that case, and the opinion issued from the 9th Circuit Court of Appeals on August 26, 2011 was both a victory for the plaintiff and good news for those suffering from mental illness in California.
In Harlick, the plaintiff, who suffers from anoxeria nervosa, sought to force Blue Shield, her insurance provider, to cover a long-term (10 month) in-patient program for treatment for her condition. While the language in her policy specifically excluded such residential programs, the 9th Circuit ruled that the treatment was medically necessary for her condition and coverage was required under California’s Mental Health Parity Act.
California’s legislation is not unique. Following a growing awareness of the disparate treatment insurance companies were giving mental health conditions over purely physical illnesses, lawmakers in a number of states adopted various types of legislative approaches to force a more level playing field for insured people suffering from mental disorders. California’s approach requires that insurance companies cover mental health treatment the same way they’d cover treatment for physical disorders.
At play in the Harlick case, the Court noted, is the requirement that insurance plans provide “coverage of all ‘medically necessary treatment’ for nine enumerated ‘severe mental illnesses,” which list includes eating disorders as well as bipolar disorder and major depressive disorder, among others.
Other states have adopted different types of legislation. (A chart outlining mental health parity laws by state can be found here, although it may be out of date and you should always consult an attorney before acting on legal information found on the internet.) Georgia’s legislation is what has been termed “mandated offering” legislation. These kinds of statutes do not require coverage, per se, but do state that mental health treatment must be offered to the individual (usually at a higher premium) and can also require that if coverage is offered and accepted, then it must be equal to the coverage provided for physical illness treatment.