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CA Department of Insurance

Insurance Commissioner Jones Files Brief Supporting Rights of People Suffering from Mental Illness

News: 2011 Press Release

For Release: November 10, 2011
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Insurance Commissioner Jones Files Brief Supporting Rights of People Suffering from Mental Illness

Insurance Commissioner Dave Jones today filed a friend of the court brief supporting the rights of people suffering from mental illness to receive full coverage from their insurers for all medically necessary treatment of their illnesses.

"Individuals suffering from mental illnesses have long faced disparity in the coverage they receive from their insurers, and the time is now to end this practice," Commissioner Jones said. "The Mental Health Parity Act was created to ensure that people affected by mental illnesses receive the coverage they need, and insurers have an obligation to abide by this critical law."

A panel of the U.S. Court of Appeals for the Ninth Circuit held several months ago that the California Mental Health Parity Act required Blue Shield of California to provide residential care treatment for a woman suffering from anorexia nervosa. Blue Shield denied coverage on the ground its health plans exclude coverage for residential care treatment. The panel held that denying coverage on that ground deprived a patient of critical services needed to treat a mental illness. The panel found that the Mental Health Parity Act creates both a mandate (all insurers must cover listed mental illnesses) and a requirement of parity (an insurer must provide that coverage on terms no more restrictive than for physical illnesses). Commissioner Jones strongly supports the panel's analysis.

The panel's decision is important not just for people suffering from anorexia nervosa. It applies to many other serious mental illnesses, including bipolar disorder, major depressive disorders, and pervasive developmental disorder or autism. The Commissioner has been particularly concerned about insurers' denial of coverage to children in need of autism treatment. The panel decision upholds their rights.

The Commissioner's brief comes in the context of Blue Shield's request to the full Ninth Circuit Court that it set aside the panel's decision. The Commissioner urges the Court to keep the panel decision on the books. Select this link to view the brief.

The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at Non-media inquiries should be directed to the Consumer Hotline at 800.927.4357. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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