Friday, March 15, 2013

APA, Connecticut Physicians Protest Insurer's Practices

The Connecticut Psychiatric Society (CPS), the Connecticut State Medical Society, and APA are protesting what they say are violations of federal laws, including the Mental Health Parity and Addiction Equity Act (MHPAEA), by Anthem Blue Cross Blue Shield of Connecticut. In a joint letter to the company, they say the company’s way of implementing new CPT codes increases the financial and time burden on patients who seek treatment from psychiatrists and discourages psychiatrists from providing psychotherapy services to their patients.

The three organizations claim that Anthem is violating state and federal laws and regulations, including the MHPAEA, the Connecticut Parity Law, HIPAA, and Unfair Insurance and Unfair Trade Practices laws as they pertain to treatment of patients with a mental or substance use disorder. They maintain that the company is covering only patient visits that are to be reported for medical evaluation and management while not covering psychotherapy as a separate and equal category for payment. In addition, the organizations say that there is a significant disparity between the reimbursement rates that Anthem is paying to psychiatrists and those paid to other medical/surgical network providers.

“We will not allow insurance companies to deny coverage that patients and their employers have paid for, nor will we ask psychiatrists to provide medically necessary psychotherapy for free to insured patients,” said CPS Executive Director Jacqueline Coleman. “These practices are both unethical and illegal, said APA Medical Director James H. Scully, Jr., M.D. “We worked very hard to enact mental health parity laws, and it is now clear that Anthem is seeking a way to avoid compliance. We are not prepared to allow them to skirt their obligations under the law."

For more information about the parity law, see Psychiatric News here and here.

(Image: Gunnar Pippel/



The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.