Healthcare Litigation

Blue Shield has used enormous rate hikes, and the threat of rate increases, to force patients into lower-benefit and higher-deductible health coverage in violation of state law, according to a class action lawsuit filed today by Blue Shield policyholders and consumer advocates.

Parents of children with autism lauded the governor's decision to sign into law a bill that requires health insurers to cover behavioral health treatments...

Appeals court sides with patient, giving hope to others

Health insurance providers can expect new litigation - and pressure from existing litigants - after a federal appellate court decision on Friday said they are responsible for covering mental health treatment on par with care for physical conditions.

Multiple lawsuits and a piece of state legislation are already underway to force insurance coverage of treatment for autism, and advocates fighting for that coverage say Friday's ruling brings momentum to their cause.

SACRAMENTO, Calif.—The California Department of Managed Health Care (DMHC) overstepped its constitutional authority in issuing a memorandum to health insurance companies on how to handle consumer complaints about autism treatment, a state judge ruled Dec. 30 (Consumer Watchdog v. California Department of Managed Health Care, Cal. Super. Ct., No. BS121397, 12/30/10).
 

LOS ANGELES - A Superior Court judge overseeing an unusual consumer lawsuit against state regulators found that a 2009 policy that has allowed health insurance plans to more easily deny coverage for some costly autism therapies constituted an "underground regulation," but has declined to intervene.

Court ruling finds regulator overstepped on memo to insurers about autism treatment complaints

 

On Other Key Issues, Ruling Leaves Autistic Children at Risk; Brown Administration Urged to Take Action

A Los Angeles County Superior Court issued a ruling late Monday finding in part that the Schwarzenegger Administration illegally changed state policy relating to autism coverage without following the required public process.  However the ruling failed to address key legal issues, including California’s mental health parity law, and leaves children at risk of additional coverage denials for autism treatments, according to Consumer Watchdog.

We have cleared the final hurdle before going to trial next Monday on our suit against the Department of Managed Health Care (DMHC), the state's largest health insurance regulator, for illegally siding with insurance companies over autism treatment delays.

Ever play a game with a poor loser who tries to change the rules when the chips are down? The Department of Managed Health Care...