Ghazarian v Magellan Health, Inc.

(November 2020) -  In Ghazarian v. Magellan Health, Inc. et al., 53 Cal.App.5th 171 (Aug. 7, 2020), the California Fourth District Court of Appeal reversed the entry of summary judgment in favor of California Physicians' Services dba Blue Shield of California ("Blue Shield") and its administrators, Magellan Health, Inc. and Human Affairs International of California (collectively, "Magellan"), in connection with a decision to reduce medical benefits related to the treatment of the plaintiffs' son for autism. The plaintiffs' son received 157 hours of therapy per month for his condition until his seventh birthday. Once the plaintiffs' son turned seven, Blue Shield, through its administrator, Magellan, reduced the amount of therapy to 81 hours a month. In response, the plaintiffs requested that the Department of Managed Health Care ("the Department") conduct an independent review of Blue Shield's denial of benefits. The Department found that 157 hours of therapy (per