Parity Track is a tool that will monitor progress in achieving quality behavioral health care in every state.
I have been a practicing attorney for almost 30 years. In 2004, my husband, Glenn Kantor, and I established the well-known law firm, Kantor & Kantor that specializes in plaintiff
ERISA and bad faith, life, health, disability and other insurance cases. The vast majority of my cases involve representing insureds who have been denied coverage for treatment for an eating disorder. Over the last 10 years, much of my work has been fighting for the rights of patients who are denied treatment on the basis of denials that violate the
Federal Parity Law. My firm currently represents over 250 clients who are suffering from eating disorders and other mental illnesses, and have been denied treatment.
In 2006, Thompkins v. BC Life Ins. Co., 414 F.Supp.2d 953 (C.D. Cal. 2006) was the first published district court decision in California in which a client was denied benefits for inpatient treatment of Bulimia Nervosa. The court applied the California Mental Health Parity Law and found that the insurer had violated parity by denying our client’s treatment. The insurer paid the benefits it should have paid.
In 2012, the United States Court of Appeals for the 9th Circuit ruled in favor of our client, Janine Harlick in Harlick v Blue Shield of California, 686 F. 3d 699 (9th Cir. 2012), holding that the California’s Mental Health Parity Act must provide coverage of all medically necessary treatment for the nine enumerated “severe mental illnesses” under the same financial terms as those applied to physical illnesses. This decision was the first of its kind in the country and has paved the way for other mental health parity rulings. That same year, in Burton v Blue Shield of California Life & Health Ins. Co., 2012 WL 242842 (C.D.Cal.), the United States District Court for the Central District of California ruled in favor of our client, deciding that California’s Mental Health Parity Act mandates that Blue Shield of California must provide benefits for
residential treatment of Ms. Burton’s major depressive and panic disorder. The Burton court relied on Harlick, pointing out the impossibility separating treatment for severe underlying mental illnesses from treatment for alcohol dependency.
On June 10, 2014, in Rea v. Blue Shield of California, 226 Cal. App. 4th 1209 (2014), the California Court of Appeal ruled in favor of our client, reversing the trial court and holding that the California Mental Health Parity Act required Blue Shield to provide all medically necessary treatment for people suffering from severe mental illnesses, including anorexia and bulimia. Blue Shield sought review of the ruling by the California Supreme Court, but the request was denied. As a result, both the federal and state courts have taken consistent positions regarding the interpretation of the Mental Health Parity Act.
I am a staunch advocate for those suffering from eating disorders and other mental illnesses because I believe that with the right treatment, these are illness from which a person can fully recover. I believe that insurance companies should be forced to honor their contractual obligations with their insureds by recognizing what the medical community has already recognized; that mental illnesses are serious, debilitating conditions that deserve the same treatment as physical ailments. Through the work I have done, I have seen firsthand that recovery is possible. My biggest reward through my work has been to watch many of my former clients go on to lead full, happy and healthy lives after receiving the treatment to which they were entitled.