Anthem Dodges a Mental Health Bias Action

MANHATTAN (CN) — Psychiatrists celebrated the Second Circuit's "watershed" decision last year opening insurers to liability for discriminating against mental health treatment, but a new ruling shows the floodgates are not open to all plaintiffs.

On Friday, the federal appeals court affirmed dismissal of similar claims by the American Psychiatric Association.

Along with related trade groups and doctors, the APA had accused Anthem and its subsidiary Wellpoint of skimping on mental health and substance-abuse care.

The lawsuit, filed three years ago in Connecticut, quoted remarks to Congress by U.S. Rep. Patrick Kennedy, when introducing the Mental Health Parity and Addiction Equity Act of 2008.

"Access to mental health services is one of the most important and most neglected civil rights issues facing the nation," the Rhode Island Democrat had said. "For too long, persons living with mental disorders have suffered discriminatory treatment at all levels of society."

The Mental Health Parity Act sought to ensure comparable coverage for mental and physical illnesses, but psychiatric associations say the statute suffers from lax enforcement.

When the Second Circuit revived a similar class action by the New York State Psychiatric Association against UnitedHealth Group, the group's lawyer hailed it as a "major" ruling that patched a perceived loophole in the statute.

NYSPA's success stemmed from the court's finding of "no serious dispute" that the association had standing to sue "in its own right."

In affirming dismissal of the APA's case Friday, the Second Circuit found that the group could not sue on behalf of its members and patients.

Supreme Court precedent shows the court "cannot expand the congressionally created statutory list of those who may bring a cause of action by importing third-party prudential considerations," the 25-page ruling states.

This is so, according to the ruling, despite "policy reasons [that] might support allowing physicians to bring suit on behalf of patients with mental health and substance use disorders in the absence of statutory authorization for such an action."

U.S. Circuit Judge Judge John Walker wrote the decision for a three-judge panel.

Anthem has not returned a telephone request for comment.

The APA's president Renee Binder complained that the ruling would further disenfranchise its patients.

"Discrimination against our patients is a pervasive and pressing problem, and we believe it needs to be addressed in a coordinated, systematic fashion," Binder said in an email. "We disagree with this ruling because, it means the patients, who are already disenfranchised, have to fight on a claim-by-claim basis. Psychiatry will continue to advocate for the interests of our patients, explore options for appeal, and implement strategies to end barriers to care."

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