Thursday, March 14, 2013

New York Psychiatrists Sue Insurer Over Parity Law Violations


The federal mental health parity law was a hard-fought victory for people with psychiatric disorders and the clinicians who treat them, but only if insurance companies adhere to the law's requirements. The New York State Psychiatric Association (NYSPA) maintains that one of the country's largest health insurers, UnitedHealth Group, including its subsidiary United Behavioral Health, are not complying with the law and has filed a class-action lawsuit to remedy that situation.

Among the charges alleged in the suit, filed in U.S. District Court for the Southern District of New York, is that the insurer has curtailed psychotherapy for patients needing long-term treatment, "allowing no more than weekly psychotherapy for patients who have attempted suicide and been hospitalized...and refusing to cover more than one weekly session of psychotherapy for actively suicidal patients." The suit also says that beneficiaries have experienced “extreme difficulty obtaining initial and continuing authorizations for intermediate levels of care, such as intensive outpatient treatment and partial hospitalization for mental health and substance abuse disorders.” NYSPA also charges the insurer with putting roadblocks in front of patients who try to obtain both "initial and continuing authorizations" for psychiatric care. The suit also cites numerous complaints alleged by three individual beneficiaries insured by United.

Over the past year we have tried to work with United to resolve these complaints but have been unsuccessful,” said NYSPA Executive Director Seth Stein. “Enforcement of existing state and federal parity statutes is necessary to ensure that individuals with mental illness have access to appropriate care and treatment.” NYSPA President Glenn Martin, M.D. told Psychiatric News, “Our state and national associations have fought for years for parity legislation, and we were mostly successful. That was only the first step, and now we find that we have to fight for full implementation of the laws and regulations. This lawsuit allows us to go on the offensive in this struggle, and we are confident we will prevail to the benefit of our patients and colleagues.”

The complaint is posted at http://www.psych-appeal.org/img/Complaint.pdf.



(image: stuart miles/ shutterstock.com)


No comments:

Post a Comment

Note: Only a member of this blog may post a comment.

Disclaimer

The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising on this site. Clinical information is not peer reviewed and thus should be independently verified.