Federal District Court Dismisses Class Claims Alleging MHPAEA Violations by Cigna and Plans for Denying Coverage for Wilderness Therapy

In a recent ruling, a federal district court dismissed putative class claims against Cigna Health and Life Insurance Co. and two employer-sponsored plans for allegedly violating the Mental Health Parity and Addiction Equity Act of 2008 by denying coverage for wilderness therapy. The court found that the plans’ exclusions of “experimental, investigational, and unproven services” justified the denial of coverage for wilderness therapy programs.

The plaintiffs in the case argued that the coverage denials violated the MHPAEA because the plans would cover similar treatments in medical/surgical settings. However, the court ultimately sided with Cigna and the plans, stating that the language of the plans clearly excluded such treatments.

This decision highlights the ongoing debate surrounding wilderness therapy and its coverage under the MHPAEA. While some courts have ruled in favor of coverage for wilderness therapy, this particular ruling emphasizes the importance of concrete evidence and specific language in insurance plans when determining coverage eligibility.

Overall, this case serves as a reminder that speculative claims may not hold up in court, and that clear and specific language in insurance plans is crucial in determining coverage for mental health and substance use disorder treatments.