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Los Angeles Times

'Bait and Switch' Alleged at Health Net

by Lisa Girion, Times Staff Writer
Apr 28, 2004

A consumer group's lawsuit alleges that Health Net Inc., one of California's largest medical insurers, failed to provide public employees in the state with the mental healthcare it promised them in its explanation of coverage.

The suit, filed in Los Angeles County Superior Court on Monday, says Health Net and a subsidiary applied a "more restrictive definition of medical necessity" that limited the type and amount of mental health care provided to its patients.

"The problem here is it's a bait and switch," said Jamie Court, president of the Foundation for Taxpayer and Consumer Rights, which filed the suit. "Members don't realize that when it comes to their mental health care, a Health Net-owned subsidiary is applying a far more restrictive standard, and that's what we're trying to stop."

Brad Kieffer, spokesman for Woodland Hills-based Health Net, said the company had not yet been served with the suit and declined to comment further.

"We can only assume that this is more of the political grandstanding that we have come to expect from the Foundation for Taxpayer and Consumer Rights," he said.

The suit also alleges that Health Net is not providing children under its plan with the care required since 2001 by the state's Mental Health Parity Act.

Court said the law requires insurers to treat severe mental disorders and serious emotional disturbances in children under the same terms as other medical conditions under the plan.

The consumer group has filed suits against other insurers challenging alleged differences between what members are told and the care actually covered.