News from the New York Attorney General’s Office

May 31, 2018

Attorney General’s Press Office / 212-416-8060


New Report Shows Health Care Bureau’s Mental Health Parity Investigations
Have Helped Transform the Industry and Provided Over $2 Million in
Restitution to Consumers

  • Since 2014 Start of AG’s Investigations, Consumer Complaints Have Dropped
    by 60%
  • Consumers Who Believe They’ve Been Treated Unfairly Should Contact AG’s
    Health Care Helpline

NEW YORK – To mark the end of Mental Health Month, Attorney General Barbara
D. Underwood today released a report detailing the work of the office’s
Health Care Bureau in enforcing state and federal mental health parity laws
over the past five years — which have helped transform the industry and
resulted in over $2 million in restitution to consumers. The report, “Mental
Health Parity: Enforcement by the New York State Office of the Attorney
General,” summarizes the results to date of the Attorney General’s Office’s
industry-wide initiative to ensure that all New Yorkers have access to
behavioral health services, such as substance abuse treatment — including
the enforcement of eight national settlement agreements with seven health

“Access to mental health services, including substance abuse treatment, is
critical to New Yorkers’ health and wellbeing,” said *Attorney General
Underwood*. “Our office is committed to enforcing mental health parity laws
to increase this access for all New Yorkers.”

In 2013, after receiving consumer complaints regarding health plans’
coverage of behavioral health treatment, the New York Attorney General’s
Office launched a mental health parity initiative and began investigations
into various health plans. Since then, the office has entered into eight
national settlement agreements with seven health plans, and has overseen
the enforcement of these agreements: MVP, EmblemHealth, Beacon Health Options
(formerly known as ValueOptions), Excellus, HealthNow, Anthem, and two settlements
with Cigna. Four of the settlements required health plans to implement sweeping reforms
in their administration of behavioral health benefits, in particular
relating to medical management practices, coverage of residential
treatment, and co-pays for outpatient treatment, and to submit regular
compliance reports. Two of the settlements focused on coverage of
particular services, and two more addressed the improper imposition of
preauthorization requirements for medication-assisted treatment (“MAT”).

Over the past four years, the Attorney General’s Office has vigilantly
monitored the health plans’ compliance with these agreements, and the
results – presented in this report – illustrate the degree to which these
agreements have contributed to the transformation of the industry’s
approach to behavioral health services. Some highlights include:

· Plans are imposing fewer barriers to necessary mental health

o Covering the continuum of care, including residential treatment.

o More consumers are able to access needed mental health care.

o Plans are denying care at a lower frequency than in previous years.

· Plans reimbursed nearly 500 consumers over $2 million for their
out-of-pocket costs for previously denied claims.

· Plans paid a total of $3 million in penalties.

· Plans are letting providers prescribe – without preauthorization
– medication-assisted treatment for patients suffering with substance abuse

Significantly, since 2014 when the Health Care Bureau initiated its
investigations, the number of consumer complaints to the Health Care Bureau
Helpline regarding mental health and substance abuse issues diminished by
nearly 60%.

Consumers who believe that they may have been treated unfairly by a health
care provider, HMO or insurance plan, or health-related business, should
contact the Attorney General’s Health Care Helpline by either calling the
Helpline at 1-800-428-9071, or by submitting a complaint form online
or by mail.

The Health Care Bureau is led by Bureau Chief Lisa Landau, together with
Deputy Bureau Chief Susan J. Cameron. The Health Care Bureau is part of the
Social Justice Division, which is led by Executive Deputy Attorney General
Matthew Colangelo.



Translate »