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Tenth Circuit Upholds Denial of Residential Mental Health Treatment

The Tenth Circuit upheld a claims administrator’s decision denying a claim for residential mental health treatment as not medically necessary. In so holding, the Court rejected plaintiff’s argument that the claims administrator’s refusal to produce data on its historical denial rates for mental health treatment warranted a de novo review because that information was not relevant to whether the benefit denial was made in accordance with the plan document.

The case is Mary D. v. Anthem Blue Cross Blue Shield, No. 16-cv-00124, 2019 WL 3072468 (10th Cir. July 15, 2019).

© 2020 Proskauer Rose LLP. National Law Review, Volume IX, Number 219

TRENDING LEGAL ANALYSIS


About this Author

Neil Shah, Proskauer Rose, Labor Rights Lawyer, ERISA Litigation Attorney,
Associate

Neil Shah is an associate in the Labor & Employment Law Department and a member of the Employee Benefits, Executive Compensation & ERISA Litigation Practice Center.

Rutgers University School of Law, Newark, J.D., 2009

 

cum laude

Order of the Coif

Managing Editor, Rutgers Law Review

Dean's Merit Scholarship

 

New York University, College of Arts & Science, B.A., 2006...

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