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Victory for Harvard Pilgrim Health Care in Residential Treatment Program Coverage Matter

by Anderson & Kreiger
March 11, 2020

We obtained summary judgment on remand from the First Circuit for our client, Harvard Pilgrim Health Care (“HPHC”) after HPHC denied coverage for a long term stay at a 24/7 residential treatment program on the basis that the patient could be safely treated in a partial hospitalization program and simply chose not to do so.  The plaintiff also sought substantial attorneys fees for her partial success at the First Circuit, but the District Court denied the fee request.  Doe v. Harvard Pilgrim Health Care, Inc., 2019 WL 3573523.