Court Moves Forward Eating Disorder Treatment Coverage Suits

A New Jersey Law Journal news report said U.S. District Judge Faith Hochberg of the U.S. District Court for the District of New Jersey turned away requests to throw out the two cases against Blue Cross Blue Shield that claimed the eating disorder treatments should be covered.  However, the cases moving forward will be dramatically stripped down versions of the original lawsuits after Hochberg also ruled that the plaintiffs’ state law claims were pre-empted by the Employee Retirement Income Security Act (ERISA).   

According to the Law Journal, the result of Hochberg’s decision was to get rid of plaintiffs’ claims under the Mental Health Parity Law and the Consumer Fraud Act, along with claims for breach of contract, breach of implied duty of good faith and fair dealing, misrepresentation, unjust enrichment and tortious interference with contract.

At issue is whether eating disorders such as anorexia and bulimia are biologically based mental illnesses, for which state law and the Horizon Blue Cross Blue Shield of New Jersey policies at issue require benefits comparable to those for physical ailments.

The plaintiffs sued on behalf of their minor daughters who allegedly were denied benefits because Horizon classified their eating disorders as not biologically based.

In June, Hochberg gave approval to a $250,000 settlement of a similar case between Aetna and policyholders with claims for treatment of anorexia and bulimia (See Eating Disorder Coverage Agreement Gets Court OK ).