From Bloomberg BNA:
An AT&T Inc. health plan must pay for an employee’s daughter’s mental health treatment at a residential center that combines psychotherapy with riding horses ( Lynn R. v. ValueOptions , 2017 BL 293893, D. Utah, No. 2:15-cv-00362-RJS-PMW, 8/22/17 ).
The health plan was wrong to deny more than $117,000 in medical claims for treatment the girl received at Utah-based Equine Journeys, a federal judge ruled Aug. 22. The plan said it denied coverage because the facility wasn’t nationally accredited, but the judge rejected this rationale. “Nowhere does the Plan state a provider must be nationally accredited for the treatment to be medically necessary,” the judge said.
