Class Action against Kaiser

[Guest guest]

*Courthouse News* released an article: " Class Action Against Kaiser

Moves Forward " by Avery Fellow.

Here are some excerpts:

[begin excerpts]

A California appeals court has reinstated a class action accusing Kaiser

Foundation Health Plan of categorically denying coverage to autism

patients for behavioral and speech therapy.

The Second District Court of Appeal overturned an order sustaining

Kaiser's demurrer to the lawsuit, filed by the guardian of a 4-year-old

autistic child.

Guillermo Arce claimed that Kaiser refused to cover the boy's

behavioral and speech therapy on the basis that the treatments were not

medical necessary.

Arce filed suit under the Unfair Competition Law, citing breach of

contract and violations of the Mental Health Parity Act, which mandates

coverage for medically necessary health care services.

Kaiser objected to the class action, arguing that it should be

thrown out because it would require looking into plaintiffs' cases on an

individual basis to determine if autism treatments were medically necessary.

<snip>

" Arce's allegations that Kaiser systematically breached its health

plan contract by refusing to provide all putative class members with

contractually covered services is sufficient to state a class action

claim under the Unfair Competition Law, " Justice Laurie Zelon wrote.

[end excerpts]

The article is online at:

<http://www.courthousenews.com/2010/01/29/24203.htm>

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