By  Alan M. Solomon, Ph.D.

Previous blogs covered issues with United Healthcare (UHC) denying mental health services to eligible patients (Will Mental Healthcare be as Available as  Medical Care?, New Guidelines for Parity of Care).  A lawsuit in New York state was resolved recently, when UHC completed $13.6 million in payments to patients who had been denied care. UHC is the nation’s largest health care insurer (https://ag.ny.gov/press-release/2022/attorney-general-james-provides-136-million-consumers-who-were-denied-mental#:~:text=NEW%20YORK%20%E2%80%93%20New%20York%20Attorney,the%20nation’s%20largest%20health%20insurer.v/) .

More than $8 million of this amount went to 20,000 New Yorkers, for whom care had been denied or reduced. UHC also paid $725,000 directly to consumers affected by their illegal decisions.

As described in the earlier blog, parity laws require mental health coverage to be equivalent to medical care, in both New York state and federally.  This federal law was enacted in 2006 at first as Timothy’s Law, and then in 2008 as the Mental Health Parity and Addiction Equity Act. 

UHC had reduced reimbursement to subscribers for psychotherapy provided by Ph.D. and masters-level therapists.  Its algorithms for monitoring care had set arbitrary thresholds to prompt reviews of care, which frequently led to denials of coverage. 

To pursue restitution payments from UHC, a patient can contact the Settlement Administrator at 866 590-8527 or by email at: mail@unitedoutpatientsettlements.com

Even earlier blogs were written about Kaiser Permanente in Northern California failing to provide adequate psychological services to its subscribers. This resulted in a record $4 million dollar fine in 2013, levied by the Department of Managed Care in Sacramento. Four years of  negotiations with Kaiser eventually resulted in their hiring providers on a contract basis to provide more services.  Southern California Kaiser has also hired outside contractors to provide therapy, though there are still lengthy delays in setting up a first appointment, and then more delays in actually beginning therapy.

Many consumers are uninformed about such issues when they consider what health insurance to choose.  Being well-informed is essential, as is active pursuit of needed services.

Dr. Alan M. Solomon, is a licensed psychologist in private practice in Torrance, CA. A member of the Independent Psychotherapy Network, he can be reached at 310  539-2772, or dralanms@gmail.com Telehealth or in-person sessions are available, or he will help with referrals to other therapists.

Copyright 2022 by  Alan M. Solomon, Ph.D.

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