On July
9th the office of New York Attorney General Eric T. Schneiderman
make the following announcement:
NEW YORK
– After an investigation uncovered widespread violations of mental health
parity laws by the company, Attorney General Eric T. Schneiderman today
announced a settlement with New York City-based EmblemHealth, Inc., requiring
the health insurer to reform its behavioral health claims review process, cover
residential treatment and charge the lower, primary care co-payment for
outpatient visits to mental health and substance abuse treatment providers. The
settlement also requires the health insurance plan -- which has 3.4 million
members in its HIP and GHI divisions -- to submit previously denied mental
health and substance abuse treatment claims for independent review. That review
could result in more than $31 million being returned to members wrongfully
denied benefits.
An investigation by the Attorney
General’s Health Care Bureau found that since at least 2011, EmblemHealth,
through its behavioral health subcontractor, Value Options (My bold.), issued 64% more denials of coverage in
behavioral health cases than in medical cases. The agreement with EmblemHealth
is the third reached by the Attorney General’s office so far this year
enforcing the mental health parity laws and stems from a broader and ongoing
investigation into health insurance companies’ compliance with the laws.
For the full text of the Attorney
General’s announcement – go here:
Today I wanted to learn more about
Value Options. Those that know me
understand I have more than a casual interest in their performance and
behavior. The first thing I saw on
their website, at the very top of the screen was an announcement about S.O.S. –
Stamp Out Stigma. See for yourself here: http://stampoutstigma.com
PLEASE correct
me if you think I’m wrong. Value
Options, which has clearly demonstrated prejudice against mental health and
substance use disorder claims, is now trying to pretend that it wants to end
the stigma against mental health and substance use disorder, even as its
actions serve to reinforce and perpetuate that stigma by denying proper claims. The fox is watching the chickens. At
the least, Value Options, should say nothing until their practice matches their
“policy.” Until then they come
across as the cynical and deceitful business I believe them to be.