$12.88M Anthem mental health treatment class action settlement
Anthem will pay $12.875 million to settle claims of denying mental health and substance use disorder treatment based on restrictive guidelines.Summary
Anthem (now Elevance Health) has agreed to a $12.875 million settlement resolving allegations that it improperly denied coverage for mental health and substance use disorder treatment. The lawsuit, *Collins, et al. v. Anthem Inc.*, claimed Anthem used overly restrictive medical necessity guidelines – specifically its Clinical UM Guidelines or MCG Guidelines – when evaluating requests for residential treatment services starting April 29, 2017. These guidelines were alleged to violate ERISA and the Mental Health Parity and Addiction Equity Act.
Individuals covered by an ERISA-governed health plan who were denied residential treatment coverage based on these guidelines may be eligible for reimbursement of out-of-pocket expenses or a nominal payment of at least $100. Claimants must submit proof of payment for treatment received within 14 days of a qualifying denial, with a maximum of 365 eligible days per treatment episode.
The deadline to file a claim is January 20, 2026, with a final approval hearing scheduled for January 26, 2026. Claim forms and further information can be found through the settlement administrator, Simpluris.
(Source：Class Action Lawsuits)