Mental Health: Enforce state insurance parity laws
The good news on the mental health front is that the state of Minnesota appears to have for the first time in recent memory actually enforced the state’s mental health parity law against an insurance company that appeared to be violating it.
The bad news seems to be such enforcement, increasingly needed, is rare.
The Minnesota Department of Commerce fined HealthPartners $150,000 for what it alleges is a violation of the state mental health parity law, which has been in place for decades. It requires companies to pay for mental health services that same way they would pay for physical health services.
The state said HealthPartners was essentially putting up barriers to pay providers delivering mental health, thereby exacerbating the huge disparities that already exist in a system overwhelmed by the recent growth in people who need mental health treatment.
The company paid mental health providers less and also challenged and audited mental health services more than it did physical health services. It reviewed patient claims for mental health services more rigorously than it reviewed claims for physical health services.
For example, the insurer excluded coverage for behavioral health residential care treatment while approving similar nursing care for physical ailments through 2018, according to the commerce department investigation.
We hope insurers don’t view this as business as usual. Insurance companies must take seriously the needs of those with mental health problems and while diligence is necessary in this business, indifference is not. HealthPartners neither admitted nor denied the allegation by the state in the consent order.
Mental health parity laws were approved decades ago, but as an in-depth Star Tribune report showed, the laws are not working for patients for a number of reasons.
The $150,000 fine is a drop in the bucket for the billion dollar health care insurer, but the requirement the state has imposed going forward should be a warning to others that the state will hold those companies to following the law. HealthPartners has agreed to corrective action which the state will monitor for one year.
The department news release says the company will implement “systemic changes” that “will remove obstacles and expand access to mental health care for Minnesotans.” Assistant Commissioner for Enforcement Jacqueline Olson said in a statement that the consent order “compels a large insurer to make major changes.”
The company agreed to pay some previously denied claims and put in place better procedures to be consistent with the parity laws.
This is not a partisan issue pitting business against government regulation. Mental health symptoms don’t choose those who suffers by political party. Political leadership in St. Paul should get behind more such audits, provide the resources to carry them out and adjust the law if need be.
— Manakto Free Press