Rea

Rea v. Blue Shield of California

Good Law
172 Cal. Rptr. 3d 823·2014 Cal. App. LEXIS 502·226 Cal. App. 4th 1209·2014 WL 2584433
Court of Appeal of CaliforniaJune 10, 2014B244314California11,456 words

Opinion

Opinion

Johnson, J.

In 1999, the Legislature enacted the California Mental Health Parity Act (Health & Saf. Code, § 1374.72) (Parity Act) to address the imbalance between medical coverage for physical illnesses and mental illnesses. The Parity Act mandated that every health care service plan contract “provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses . . . under the same terms and conditions applied to other medical conditions.” (§ 1374.72, subd. (a).) At issue in this appeal is whether the Parity Act requires coverage for residential treatment for the eating disorders anorexia nervosa and bulimia nervosa even where the health plan does not provide coverage. In Harlick v. Blue Shield of California (2012) 686 F.3d 699 (Harlick), the Ninth Circuit found that the Parity Act, which requires coverage for all “medically necessary treatment” for “several mental illnesses” mandated the coverage of residential care treatment for such eating disorders. The trial court here disagreed, holding that the statutory language of the Parity Act and the statutory scheme of the Knox-Keene Health Care Service Plan Act of 1975 (§§ 1340-1399) (Knox-Keene Act) (of which…

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