Huge Victory on Mental Health Parity in California

Peter Forster Costs of Treatment, Policy

On September 10th the California Supreme Court let stand a California Appeals Court decision that the California mental health parity law requires coverage of treatment that may have no equivalent in other medical specialties. Specifically, the Appeals Court held that Blue Shield of California must cover residential treatment for eating disorders.

The Court noted that residential treatment was among the most effective treatments for eating disorders.

Even though residential treatment is not an aspect of care for non-mental health conditions,  the court ruled that the principles of parity (that effective treatment would not be denied because it was treatment of a psychiatric condition) required coverage of this type of treatment.

The Court wrote –

“We do not interpret the concept of “parity” to require treatments for mental illnesses to be identical to those mandated for physical
illnesses; rather, given the principle that treatments for the two types of illnesses are in many cases not comparable, parity instead requires treatment of mental illnesses sufficient to reach the same quality of care afforded physical illnesses.”

This broad interpretation of parity was a clear win for mental health coverage in California.

Combined with a recent California law that increases the number of staff in the Department of Insurance for parity enforcement, and an Insurance Commissioner in California (Dave Jones) who seems committed to parity enforcement, this represents a signal that over the next two years we have a unique opportunity to truly implement mental health parity in this state.

Now the key question will be this, do all of us, patients, providers, and others, insist on parity, and vigorously appeal actions that violate the spirit of the parity law.