Rea v. Blue Shield: class action against Blue Shield of California finding the insurer must pay for medically necessary treatment, even though their plans specifically excluded it. Blue Shield was the only California insurance company that specifically excluded residential treatment in its plans, and the panel’s decision on this case is recognition of the importance of such treatment for mental health care.
Harlick v. Blue Shield: landmark appellate court decision that ruled health plans must pay for all medically necessary treatment of severe mental illnesses under the same financial terms and conditions as they provide for physical illnesses. In particular, this ruling will help thousands of people suffering from eating disorders receive residential treatment crucial for recovery.
Burton v. Blue Shield of California: first decision interpreting Harlick and deciding that California’s Mental Health Parity Act mandates that insurers provide benefits for residential treatment for major depressive disorder and panic disorder.
Shepard v. United HealthCare: Ms. Kantor successfully petitioned the California Department of Managed Health Care on behalf of a client with anorexia being discharged from a residential care facility, forcing her insurer to agree to pay for her treatment.
Jacobs v. Kaiser Foundation Health Plan: Ms. Kantor recovered benefits for a client suffering from bulimia when her medical plan declined to refer her to an out-of-plan treatment facility and refused to pay for the cost of treatment. The California Court of Appeal ruled that the decision to place the plaintiff in residential treatment, rather than follow the health insurers flawed treatment decisions, may have saved her life.
Thompkins v. BC Life & Health Insurance Co.: the first published appellate decision in California for an eating disorder case where her client was denied benefits for in-patient treatment of bulimia. The Court of Appeal interpreted California’s mental health parity law to include beneficiaries from California policies who did not live in California and sought medical care outside of California.