Welcome!

News Feed Item

Kantor & Kantor LLP: U.S. Supreme Court Declines Blue Shield's Request to Overturn Ninth Circuit Ruling Requiring Health Plans to Cover Residential Treatment for Eating Disorders

Decision Ends Jeanene Harlick's Long Struggle to Receive Insurance Benefits for Recovery

LOS ANGELES, March 5, 2013 /PRNewswire/ -- Kantor & Kantor LLP announced today that the U.S. Supreme Court denied Blue Shield of California's petition for writ of certiorari, successfully ending Jeanene Harlick's nearly eight-year struggle to obtain benefits for residential treatment for her eating disorder. In denying to hear the case, the Court let stand a June 2012 Ninth U.S Circuit Court of Appeals ruling that the California Mental Health Parity Act requires health plans to provide coverage of "all medically necessary treatment" for "severe mental illnesses" under "the same financial terms as those applied to physical illnesses," even if the policy excludes residential treatment.

"Health plans should give all the reasons for a denial of benefits at once, rather than waiting years to inform policyholders of new reasons for the initial denial," said Harlick's lawyer Lisa Kantor. "Blue Shield never questioned the medical necessity of Harlick's treatment at the outset, but argued it had the right to do so after it became aware California law invalidated its policy language denying treatment. Under that theory, policyholders would be forced to wait years for recovery as insurers work through their list of reasons to deny coverage."

Jeanene Harlick has suffered from anorexia for more than 20 years. In 2006, her physicians recommended treatment at a facility qualified to treat eating disorders.  Although Blue Shield agreed to pay for the treatment, after 10 days it denied coverage, saying the plan did not cover residential treatment even though the insurer agreed the treatment was medically necessary. 

In July 2008, Kantor sued Blue Shield on Harlick's behalf, arguing, among other things, that Blue Shield's health plan violated the California Mental Health Parity Act.  Blue Shield argued that it properly denied coverage under the terms of the plan, and the district court agreed. Harlick appealed, and the Ninth Circuit ruled in her favor.

Blue Shield requested a rehearing and a rehearing en banc.  The California Department of Insurance filed a Brief of Amicus Curiae (friend of the Court), opposing Blue Shield's requests and supporting Harlick's position.  The Department of Managed Healthcare did not file a brief in the matter, despite its responsibility for regulating health care service plans in California. 

On June 4, 2012, the Court denied the request for rehearing and rehearing en banc, withdrew its prior opinion of August 26, 2011, and issued a majority opinion by Judge William A. Fletcher with a dissenting opinion by Judge N.R. Smith.  Blue Shield immediately filed another request for rehearing and rehearing en banc, which was denied by the Court. After that, Blue Shield petitioned the U.S. Supreme Court.

The case is California Physicians' Service dba Blue Shield of California v. Harlick, U.S. Supreme Court, No. 12-457.

For more information about Lisa Kantor and legal assistance for eating disorders, follow this link: http://www.kantorlaw.net/Areas_of_Practice/Eating_Disorders.aspx.

About Kantor & Kantor, LLP

Kantor & Kantor is one of the largest law firms in the country exclusively representing plaintiffs who have been denied insurance benefits under life, health, disability and long-term care policies. The firm has extensive experience with the complex appeals process and federal court litigation of ERISA matters, as well as the handling of Insurance Bad Faith matters.  For more information, log on to www.kantorlaw.net, call (800) 446-7529, or follow the firm at www.californiainsurancelawyerblog.com.

SOURCE Kantor & Kantor LLP

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
"I think DevOps is now a rambunctious teenager – it’s starting to get a mind of its own, wanting to get its own things but it still needs some adult supervision," explained Thomas Hooker, VP of marketing at CollabNet, in this SYS-CON.tv interview at DevOps Summit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"We are still a relatively small software house and we are focusing on certain industries like FinTech, med tech, energy and utilities. We help our customers with their digital transformation," noted Piotr Stawinski, Founder and CEO of EARP Integration, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"We've been engaging with a lot of customers including Panasonic, we've been involved with Cisco and now we're working with the U.S. government - the Department of Homeland Security," explained Peter Jung, Chief Product Officer at Pulzze Systems, in this SYS-CON.tv interview at @ThingsExpo, held June 6-8, 2017, at the Javits Center in New York City, NY.
In the enterprise today, connected IoT devices are everywhere – both inside and outside corporate environments. The need to identify, manage, control and secure a quickly growing web of connections and outside devices is making the already challenging task of security even more important, and onerous. In his session at @ThingsExpo, Rich Boyer, CISO and Chief Architect for Security at NTT i3, discussed new ways of thinking and the approaches needed to address the emerging challenges of security i...
"We're here to tell the world about our cloud-scale infrastructure that we have at Juniper combined with the world-class security that we put into the cloud," explained Lisa Guess, VP of Systems Engineering at Juniper Networks, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"I will be talking about ChatOps and ChatOps as a way to solve some problems in the DevOps space," explained Himanshu Chhetri, CTO of Addteq, in this SYS-CON.tv interview at @DevOpsSummit at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
In his session at 20th Cloud Expo, Mike Johnston, an infrastructure engineer at Supergiant.io, discussed how to use Kubernetes to set up a SaaS infrastructure for your business. Mike Johnston is an infrastructure engineer at Supergiant.io with over 12 years of experience designing, deploying, and maintaining server and workstation infrastructure at all scales. He has experience with brick and mortar data centers as well as cloud providers like Digital Ocean, Amazon Web Services, and Rackspace. H...
"We are an IT services solution provider and we sell software to support those solutions. Our focus and key areas are around security, enterprise monitoring, and continuous delivery optimization," noted John Balsavage, President of A&I Solutions, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
What sort of WebRTC based applications can we expect to see over the next year and beyond? One way to predict development trends is to see what sorts of applications startups are building. In his session at @ThingsExpo, Arin Sime, founder of WebRTC.ventures, discussed the current and likely future trends in WebRTC application development based on real requests for custom applications from real customers, as well as other public sources of information.
Your homes and cars can be automated and self-serviced. Why can't your storage? From simply asking questions to analyze and troubleshoot your infrastructure, to provisioning storage with snapshots, recovery and replication, your wildest sci-fi dream has come true. In his session at @DevOpsSummit at 20th Cloud Expo, Dan Florea, Director of Product Management at Tintri, provided a ChatOps demo where you can talk to your storage and manage it from anywhere, through Slack and similar services with...
The financial services market is one of the most data-driven industries in the world, yet it’s bogged down by legacy CPU technologies that simply can’t keep up with the task of querying and visualizing billions of records. In his session at 20th Cloud Expo, Karthik Lalithraj, a Principal Solutions Architect at Kinetica, discussed how the advent of advanced in-database analytics on the GPU makes it possible to run sophisticated data science workloads on the same database that is housing the rich...
DevOps at Cloud Expo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to w...
SYS-CON Events announced today that Massive Networks will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Massive Networks mission is simple. To help your business operate seamlessly with fast, reliable, and secure internet and network solutions. Improve your customer's experience with outstanding connections to your cloud.
"We want to show that our solution is far less expensive with a much better total cost of ownership so we announced several key features. One is called geo-distributed erasure coding, another is support for KVM and we introduced a new capability called Multi-Part," explained Tim Desai, Senior Product Marketing Manager at Hitachi Data Systems, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
FinTechs use the cloud to operate at the speed and scale of digital financial activity, but are often hindered by the complexity of managing security and compliance in the cloud. In his session at 20th Cloud Expo, Sesh Murthy, co-founder and CTO of Cloud Raxak, showed how proactive and automated cloud security enables FinTechs to leverage the cloud to achieve their business goals. Through business-driven cloud security, FinTechs can speed time-to-market, diminish risk and costs, maintain continu...