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With the passing of Mental Health Parity many who suffer from eating disorders will finally (albeit slowly-see how your state ranks) be able to begin receiving adequate insurance coverage and necessary treatment needed for long term recovery goals. Great progress without a doubt.
But there is a Judge by the honorable name Faith Hochberg who is rockin‘ the houses of Aetna, Horizon- Blue Cross/Blue Shield who has recently ruled:
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- approval Tuesday to a class action settlement that requires Aetna Insurance Co. to provide about $300,000 in back payments to 119 insureds whose benefits for eating disorders were limited.
The company also promised to treat future claims more liberally and make internal reforms to resolve disputes over benefits for eating disorders.
U.S. District Judge Faith Hochberg also approved a $350,000 payment to the plaintiffs’ class counsel, Nagel Rice in Roseland, N.J. All of the fee comes from Aetna, not out of a percentage of the class members’ recovery.
“It makes perfect sense to me,” Hochberg said after ruling that the settlement in De Vito v. Aetna, 07-418, was fair, reasonable and adequate.
The settlement requires the company to treat some claims for anorexia and bulimia as it does claims for biologically based mental illnesses, such as schizophrenia. That makes a class of eating-disorder patients eligible for eight months of treatment, compared with 20 outpatient visits per calendar year and 30 days of inpatient benefits.
The 119 insureds who will receive checks were those who had at least one claim limited by Aetna’s practices during the past seven years. And in the future, Aetna will treat anorexia and bulimia the same way it does BBMIs.
In addition, anyone Aetna determines to have no medical necessity for enhanced eating-disorder treatment during the next four years would have the right to elect binding review by an independent eating-disorder specialist selected with input from the plaintiffs’ lawyers.
At the same time, though, the settlement affects only patients in “fully insured” plans — those funded by employers. Enrollees in self-funded plans, such as employee welfare and state worker health benefits programs, are not covered by the settlement and would not automatically benefit from the more liberal process.
Nagel estimates that about 530,000 of Aetna’s 1.2 million insureds are eligible for the new claims procedures and that the process could be worth up to $2 million in recoveries by the insureds.
-Law.com

As many of us already know recovering from an eating disorder takes time, patience, perseverance and an added sense of humor never hurts either. This journey of Hope, Change and Healing can be a long road, but well worth every step! And when a sufferer is not able to obtain the adequate and experienced care that is required for ED treatment this journey can seem like climbing the Himalayas.
Families and sufferers can have a voice and advocate for the care and support they deserve, but it takes some persistence and not taking “no” for an answer but digging deeper and rooting out the resources and connections one needs to help along this road.
One courageous and honorable teen diagnosed with anorexia has taken such a step in Northern Ireland, and is demanding change all the way to the courts to get the care she needs- bravo!
With fire-in-the-heart like that, the sky is the limit to what can be possible so that everyone suffering from this illness will eventually have access and covered care that they need to fight the battle and win their full and healthy lives back.
-shanti

President Signs Mental Health Parity Legislation!
Thanks to the thousands of Advocacy Network members who lent tireless support to our years-long effort to win enactment of legislation to end discrimination in mental health coverage. Today we won! After House passage of the Emergency Economic Stabilization Act today, 263-171, President Bush has at last signed mental health/addiction parity into law.
Click here to learn more about the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.
-Fantastic news worth celebrating!

A wonderful non-profit organization created by Gail Schoenbach For Recovery and Elimination of Eating Disorders – F.R.E.E.D. will be holding a Mother-Daughter Workshop in conjunction with the Eating Disorders Association of New Jersey Saturday, October 18th from 9:30AM-2:30PM at Summit Medical Group.
The workshop’s aim is to “engage women and girls as they explore and challenge their beliefs about themselves, their bodies, and body image”. Freelance journalist, blogger and author, Courtney E. Martin who wrote Perfect Girls, Starving Daughters will be the keynote presenter along with therapist, Suzanne Rubinetti.
F.R.E.E.D.’s mission is to:
- Provide financial support for treating eating disorder (a major hindrance for sufferers and their families in obtaining treatment/recovery resources as well as follow-up care — F.R.E.E.D.’s priority and focus on this issue is to be commended).
- Increase public awareness and provide educational resources.
- Advocate for the acknowledgement and acceptance of Eating Disorders as a serious and urgent disease.
Ms Schoenbach’s own battle with ED and body image issues took place in silence for years until she began the slow process of recovery, and it was during this healing time that she found a passion and drive to create F.R.E.E.D. and her additional adjunct G.R.Schoenbach Foundation which holds annual fund-raising events and campaigns to continue her committed work.
Organizations like these are inspiring, so if you live in the New Jersey area, are a mother with a daughter with/without an eating disorder, go partake in “day of empowerment”, sharing, support and learning– it will do the body&mind good!
-shanti








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