In a May 6 commentary on the website Tennessean.com, the author of the eating disorder memoirs Life Without Ed and Goodbye Ed, Hello Me called for a comprehensive effort to eradicate eating disorders. E.D. survivor Jenni Schaefer wrote that improved education, better-funded research efforts, and greater insurance coverage are essential weapons in the fight against anorexia, bulimia, and related disorders:

Without help, many people [who have eating disorders] struggle for years and, if they do survive, they end up with serious long-term health consequences.

We have our work cut out for us if we care about turning these stories around. First, we must fight for insurance coverage to include eating disorders in every state. We must also call on Congress to insist that the National Institute of Mental Health significantly increase funding for research of eating-disorder treatment and prevention. In the U.S., eating disorders are much more common than Alzheimer's disease, but receive only a fourth of the amount of research funding.

Several other experts and advocates have noted that challenges related to awareness and financial resources prevent many people from accessing effective treatment for eating disorders.

Labels: awareness, eating disorders, insurance

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Horizon Blue Cross of New Jersey has reached a settlement agreement in a lawsuit over its lack of coverage for eating disorders. The settlement requires Horizon to expand coverage for more than one million eating disorder patients who are currently insured through the company.

Horizon also agreed to treat any future eating disorder claims by 1.5 million of its 3.3 million insureds as they would claims for biologically-based mental illnesses (BBMI) like schizophrenia - reforms that will cost the company an estimated $17.8 million. (Source: New Jersey Law Journal)

Horizon will also be required to pay nearly $2.5 million in restitution for previously refusing to cover treatment for eating disorders.

Experts estimate that as many as eight million Americans (seven million women and one million men) suffer from anorexia nervosa, bulimia nervosa, binge eating disorder, or another type of disordered eating. In the absence of appropriate treatment, the health effects of eating disorders can range from devastating to deadly.

Labels: eating disorders, lawsuit, insurance

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Parents in Missouri traveled to the state capitol to voice their support for a piece of legislation that would give better medical coverage to people with eating disorders.

"[The bill] was filed Friday by state representatives Rachel Storch (D) and Rick Stream (R). The bill would ensure patients with eating disorders are given the same level of insurance coverage as those with other medical conditions."

If the bill passes, Missouri will become the latest in a succession of states that now require comparable medical coverage for people with eating disorders.

It is estimated that as many as nine million Americans suffer from eating disorders. Source: KSDK Channel 5 (St. Louis)

Labels: legislation, insurance, medical_coverage

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If Illinois lawmakers have their way, theirs will become the 17th state to mandate better insurance coverage for patients with eating disorders. The legislation has already been passed and is waiting for Governor Rob Blagojevich's signature.

"The cost of treatment, which often requires a team of clinicians, is one of the biggest obstacles to healing.... As with other serious illnesses, early intervention can save victims' lives and insurers' money, before patients end up in the intensive-care unit...."

Critics of these types of mandates have voiced their protests in nearly every state where similar legislation has been passed. They cite inevitable rises in health care premiums as their primary concern. Despite those protests, the mandates are largely viewed as being long overdue. Source: Chicago Tribune

Labels: treatment, insurance, costs

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Following in the footsteps of previous states, the Illinois legislature has introduced a bill that would require insurance companies to cover the treatment of eating disorders. Eating disorders are currently not recognized as a serious mental illness, so insurance companies aren't required to cover treatment.

"But that could soon change. A law proposed in the General Assembly would add anorexia and bulimia to the list of serious mental illnesses that must be covered. Insurance companies would be required to cover 45 days of in-patient care and 60 visits of outpatient treatment."

Insurance company spokespeople warn that requiring more coverage could result in higher insurance costs. Source: Chicago Daily Herald

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Labels: treatment, support, insurance

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A lawsuit filed by about 100 New Jersey insurance customers has forced Aetna to agree to change its coverage for eating disorders. It will now cover eating disorders the same way it covers other mental illnesses.

"The company previously allowed 20 outpatient visits per year and 30 days of inpatient treatment...Aetna says it would pay for more care."

The insurance company has also agreed to pay $250,000 to the families involved in the lawsuit. Source: South Jersey Courier Post

Labels: insurance, lawsuite

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A federal judge in Newark, New Jersey has ruled that a class-action lawsuit against the Aetna insurance company can proceed. The lawsuit specifically targets Aetna's policy on eating disorders and seeks to force them to improve their benefits coverage.

"The crucial issue... is whether eating disorders are biologically based mental illnesses (BBMI), for which insureds are entitled under contracts and state laws around the country to a higher level of coverage than is provided for purely mental conditions."

At the center of the lawsuit is father Frank De Vito, whose daughter was denied coverage for eating disorder treatment. Aetna called the treatment "not medically necessary." Read more at Law.com.

Labels: insurance, health_care, mental_illness

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In North Carolina, mental health-related insurance reform is one step closer to becoming reality. Called the "mental health parity bill", it would require private insurers to cover treatment of psychiatric diseases like eating disorders and schizophrenia. The measure was unanimously passed by the Senate Health Committee on Wednesday and will now be voted on by the full Senate.

"The North Carolina bill is considered a major reform and a step toward ending discrimination against those with psychiatric diseases by mental health providers and advocates."

Coverage for hospital stays and office visits can be limited for most mental health issues except nine that are considered the most serious. Read more at News-Record.com.

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Labels: treatment, mental_health, insurance

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Eating disorder treatment facilities are expensive. Some families pay out-of-pocket, but many can't afford to and turn to their insurance companies for help. Unfortunately, many insurance companies severely limit the amount of coverage they offer. Kitty and Mark Westin know this first hand. They spent a lot of time an effort fighting their insurance agency when their daughter, Anna, was struggling with an eating disorder. In hopes of helping other families in similar situations, they list several suggestions on their website.

"It is also important to understand which covered treatments are funded through the 'health' section of your plan and which are funded through the 'mental health' section. For example, your psychiatrist and medical doctor will be funded through 'health benefits' and you should insist that these are billed this way. You will probably have lower co-pays and services will not be as limited."

The Westins offer suggestions also if you find yourself having to file an appeal with your insurance company. Read more at AnnaWestinFoundation.org.

Labels: insurance, costs, health care

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Helping a child recover from an eating disorder can be a long, scary, and expensive process. Long-term, live-in facilities can cost tens of thousands of dollars a month, and most insurance agencies don't cover any of the expenses for long-term care. Several New Jersey families have recently filed a class-action law suit against insurance companies, stating that they are violating the mental health parity act that requires biologically based disorders to be covered by medical insurance.

"The National Institute of Mental Health... says that 'several family and twin studies are suggestive of a high heritability of anorexia and bulimia' and that, while no gene has been found linking eating disorders with inheritability, 'scientists suspect that multiple genes may interact with environmental and other factors to increase the risk of developing these illnesses.'"

New Jersey's definition of "biologically based" disorders includes things like obsessive compulsive disorder, and depression, both of which are often linked to eating disorders and may provide further proof that the disorders are in fact biologically based. Read more at CourierPostOnline.com.

Labels: treatment, insurance, costs

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