Blue Shield of Virginia v. McCready

457 U.S. 465
Brief Filed: 1/82
Court: Supreme Court of the United States
Year of Decision: 1982

Read the full-text amicus brief (PDF, 558KB)

Issue

Whether an insured patient receiving psychotherapy has standing to sue for treble damages under antitrust laws (i.e., the Clayton Act) when third party payors refuse to reimburse psychologists for mental health services unless those services are billed by physicians

Index Topics

Antitrust; Psychologists' Scope of Practice/Reimbursement for "Mental Health" Services

Facts

After her claims for treatment by a psychologist were denied, McCready, a mental health consumer, brought a class action antitrust suit against Blue Shield for limiting the prepaid health plan's mental health coverage to psychiatrists resulting in higher mental health care costs and limited choice of treatment providers. She alleged violations of Section 1 of the Sherman Act and requested treble damages under Section 4 of the Clayton Act. The district court granted Blue Shield's motion to dismiss, holding that consumers did not have standing to sue under the Clayton Act. The Fourth Circuit reversed, holding that McCready, representing the class, had standing under the Clayton Act to seek treble damages for the insurer's alleged violation of Sherman Act by refusing to reimburse subscribers for psychotherapy performed by psychologists. The U.S. Supreme Court granted certiorari.

APA's position

APA submitted a brief arguing that: (1) psychologists are fully trained and qualified to provide mental health services; (2) Blue Shield and physicians have long entertained anti-competitive policies toward psychologists resulting in increased costs to consumers; (3) McCready and others had standing to sue.

Results

The U.S. Supreme Court affirmed the Fourth Circuit, holding that McCready had standing to sue under Section 4 of the Clayton Act.