WASHINGTON, June 20, 2017 /PRNewswire/ -- Zuckerman Spaeder LLP, Grant & Eisenhofer P.A., and Psych-Appeal, Inc. today announced that a class has been certified in a lawsuit against Blue Shield of California and Human Affairs International of California, Inc., a subsidiary of Magellan Health, Inc., alleging that the companies improperly restricted insurance coverage for mental health and substance use treatments. On behalf of participants and beneficiaries of Blue Shield of California health plans, Zuckerman Spaeder partners D. Brian Hufford and Jason S. Cowart, along with co-counsel Daniel L. Berger and Kyle J. McGee from Grant & Eisenhofer, and Meiram Bendat from Psych-Appeal, Inc., allege that the insurers' proprietary internal guidelines improperly restrict coverage for residential and intensive mental health and substance use treatment.
According to the complaint in Charles Des Roches, et al. v. California Physicians' Service, et al., the criteria used by Magellan and Blue Shield systematically restrict coverage for claimants seeking these levels of care "unless such claimants can meet a set of requirements entirely different from, and often conflicting with, the generally accepted professional standards for treatment." The complaint alleges that the companies' criteria directly violates the terms of the health plans administered by Magellan and Blue Shield, and the legal and fiduciary responsibilities they owe to plan participants and beneficiaries. The decision of the U.S. District Court for the Northern District of California certified the action to proceed as a class action on behalf of participants and beneficiaries who sought and were denied coverage for residential and intensive outpatient treatment for mental health and substance use disorders from January 1, 2012 to the present.
"With yet another class certification, the courts are clearly recognizing the troubling pattern of behavior around insurers' handling of mental health claims," said Mr. Hufford. "In this case, Magellan and Blue Shield applied an unreasonably restrictive standard to plan holders seeking treatment for mental health and substance use disorders. This class certification offers new hope for patients with severe mental illnesses, for whom access to residential treatment can be a life-or-death issue."
About Zuckerman Spaeder LLP
Founded in 1975, Zuckerman Spaeder is a national litigation boutique that represents individual and institutional clients in high-stakes civil and criminal cases. Zuckerman Spaeder counts among its ranks many of the nation's leading lawyers, who include former federal prosecutors and public defenders, as well as attorneys who have served in congressional offices and federal agencies. The firm is frequently named to The National Law Journal's "Midsize Hot List," and was recognized by The American Lawyer as a finalist for its "Litigation Boutique of the Year" each year it has selected firms for such distinction. Zuckerman Spaeder is also the top-listed firm for white collar criminal defense in Best Lawyers, with more attorneys recognized in that category than any other firm in the country, and U.S. News and World Report ranks the firm in its top tier nationally for commercial litigation. The firm's attorneys have extensive experience in matters related to securities violations, tax controversy, political law, legal ethics, food and drug law, and health care fraud. For more information, visit zuckerman.com.
About Grant & Eisenhofer P.A.
Grant & Eisenhofer is one of the top litigation and arbitration firms in the United States. The Firm represents institutional investors from across the globe in U.S. and international securities class actions, derivative lawsuits, antitrust suits, bankruptcy litigation and other complex litigation matters. The Firm has more than 60 attorneys, with offices in Wilmington, New York and Chicago, and an international docket of high-profile cases. G&E has recovered more than $28 billion in the last 10 years and has twice been cited by RiskMetrics for securing the highest average investor recovery in securities class actions. G&E has been named one of the country's top plaintiffs' law firms by The National Law Journal for the past 13 years, and was named one of the nation's "Most Feared Plaintiffs Firms" by Law360 every year since the inception of the list. For more information please visit www.gelaw.com.
About Psych-Appeal, Inc.
Los Angeles-based Psych-Appeal, Inc. is a law firm exclusively dedicated to mental health insurance claims, advocating on behalf of patients, clinicians and treatment facilities to overcome insurer denials of treatment. For more information, visit www.psych-appeal.com.
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SOURCE Zuckerman Spaeder LLP