Helping News November, 2016 Issue 101
Health Insurers not complying with mental health parity law, and not facing consequences for violating the law
It's been seven years since the "Mental Health Parity Law," went into effect, and yet many, if not all health insurers, are not complying as required! The Law summarizes the following:
Health plans were not not be imposing arbitrary limits on covered inpatient days or outpatient visits for behavioral health coverage.
Group health plans were not to be applying separate deductibles or higher cost sharing for outpatient mental health services.
There was to be improved coverage for mental illness treatment in your group health plan in 2010, e.g. lower cost sharing, a lower deductible or elimination of a treatment limitation such as a cap on outpatient visits.
And group health plans were not to be using separate deductibles that apply only the plan's behavioral health benefit.
In addition to violating the Parity Law, and even more disturbing, is the evidence that many insurers have begun denying claims for mental health services as much as two times the rate of medical claims (NAMI statistics).
The consequences for violating the Parity Law: virtually nothing, little or no enforcement has allowed the insurers to make up their own rules as they go. In fact, some major insurance companies have become so brazen, the have begun investing much more time and energy suing providers for giving "fee forgiveness" to their patients! This effort is obviously having a devastating effect on patients, by limiting their ability to seek out services that are needed, but too costly for them.
In response, CCG has continued to run a validated Ohio Web Poll that addresses these Parity Compliance concerns, and so far the results reflect very poorly on insurance companies as a whole. This poll will continue indefinitely, to keep a running total of responses reflecting insurers actions. Please go to: Ohio Web Poll, and so far the results reflect very poorly on insurance companies as a whole. This poll will continue indefinitely, to keep a running total of responses reflecting insurers actions.
More information coming...