U.S. Court in Massachusetts Finds Third-Party Administrator Failed to Provide Fair Process in Out-of-Network Mental Health Treatment Denial
- December 16, 2022
Health plan administrator Harvard Pilgrim Health Care, Inc. (HPHC) did not provide fair process under the Employee Retirement Income Security Act (ERISA) to a beneficiary when it denied coverage of her treatment at an out-of-network mental health facility without properly considering and weighing her providers' opinions, a federal court in Massachusetts held December 12.
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