Allow
me to congratulate and celebrate those of you in recovery here today. Our son, William, cannot be with us
this morning to share his recovery story.
I’ll do my best in his stead– offering my two cents worth in three minutes.
In
October of 2012 William went with his bag packed to Beth Israel Hospital in
Manhattan. William had been
injecting heroin, using benzodiazepines purchased on the street, and consuming
alcohol. Aware and afraid he might
die, he asked to be admitted to inpatient detox. His insurers, Emblem Health and their Utilization Review
provider, Value Options, quickly determined that inpatient detox was “not
medically necessary.”
William
is not here to share his recovery story today, because there is no recovery
story. Four days after he was
denied treatment William accidentally overdosed. His heart stopped beating. He was revived by an EMS team and
hospitalized for six weeks, by which time it was clear that grievous damage was
done. Deprived of oxygen for too
long, William’s brain had withered to a point of no recovery. He was removed
from life support and died in our arms.
Laws
exist which ought to have prevented William’s denial of treatment. Unfortunately
we have yet to achieve full implementation of the federal Mental Health Parity
and Addiction Equity Act of 2008 nearly a decade after President Bush signed it
into law. The Act requires
insurers to treat illnesses of the brain, such as depression and addiction, the
same way they treat illnesses of the body, such as diabetes and cancer. In the State of New York Timothy’s Law,
permanently passed by the state legislature in 2009, requires similar parity.
Yet insurers continue to ignore these laws, or scheme to avoid the responsibility
imposed upon them by the law. Dodge, delay, and deny is a prescription for
profit, not for treatment.
In 2014 New
York’s Attorney General Eric Schneiderman announced a settlement, an Assurance
of Discontinuance, with Emblem Health for wrongly denying mental health and
substance abuse treatment for thousands of New York members. A similar
settlement with Value Options was reached in 2015. These are but two of several such settlements reached by the
Attorney General with insurers in the past few years.
Our
family has an ongoing lawsuit against Emblem Health and Value Options due to
their denial of treatment for William.
I tell you this, because as Friends of Recovery it is incumbent upon us all
to be the foes of any and all who would deny recovery. All of us must engage in
ways large and small to demand and ensure compliance that results in treatment
and recovery for all. No one should have to hold their dying child.
We
are faced with the difficult process of changing hearts and minds. That means talking to minds that have
no heart, talking to hearts that have no mind, and talking to those who have
neither but believe they have the best of both. It can be daunting. We must not back off.