Monday, September 23, 2013

APA Files Amended Complaint Against Insurer Over Parity-Law Violations

APA announced today that it has filed an amendment to its complaint against Anthem Health Plans Inc. in Connecticut and its parent company, Wellpoint Inc. Also joining in the amended action are the Connecticut Psychiatric Society and the Connecticut Council for Child and Adolescent Psychiatry. The original lawsuit was filed in April and maintains that Anthem is in violation of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and Connecticut's insurance parity law as a result of changes the company made to its rate schedules for services provided to psychiatrists after changes to CPT codes went into effect in January.

The complaint asked the insurer and the Connecticut Insurance Division to fix problems inherent in its rate schedule that make it more difficult or expensive for patients to receive psychotherapy from a psychiatrist. The complaint alleges that through its rate schedule, Anthem is forcing psychotherapy patients to make two appointments, thus missing more time from work and imposing an unfair financial burden on them. It also calls for fixes to Anthem's practice of reimbursing psychiatrists less than other physicians for evaluation and management services.

The amended complaint was filed to address changes Anthem made in its rate schedule after the original complaint was filed because, "Sadly, neither Anthem nor the Connecticut Insurance Division have made any effort to solve the problem," said APA President Jeffrey Lieberman, M.D. The insurer's action, he emphasized, "is an example of the kinds of barriers to care insurance providers impose on people with mental illness.... The MHPAEA is a good law that needs to be enforced so that people in need of mental health care do not slip through the cracks. We can no longer tolerate discriminatory practices that impede access to care."

To read about an APA letter to Anthem calling for changes to the insurer's payment policies, see the article "APA, Connecticut Psychiatrists Protest Insurer's Practices" in Psychiatric News.

(image: Alex Millos/


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