Modern Healthcare (10/31, Meyer, Subscription Publication) reports a federal lawsuit, seeking class-action status, filed against Health Care Service Corporation (HCSC) claims the insurer “is unlawfully denying behavioral health benefits to members in violation of generally accepted medical standards.” The complaint claims HCSC, which “runs Blue Cross and Blue Shield plans in five states,” unlawfully denied coverage “to a young Chicago-area woman suffering from depression, substance use disorder, and borderline personality based on faulty guidelines issued by MCG Health in Seattle” last year. The article says that MCG’s guidelines used by HCSC are “much more restrictive than generally accepted medical standards issued by the American Psychiatric Association,” according to the lawsuit.
Related Links:
— “Major Blues insurer sued for denying behavioral health claims, “HARRIS MEYER, Modern Healthcare, October 31, 2019