News: Insurers failed to comply with mental health coverage law, Department of Labor report shows

Health plans and insurers participated in widespread noncompliance and violations of federal law regarding coverage of mental health care, according to a United States Department of Labor recent report. They found that companies administering health plans have excluded key behavioral treatments (such as therapies for substance use and autism) and offered inadequate networks of mental health providers, ProPublica reported.

The report cited findings from secret shopper surveys of more than 4,300 mental health providers listed in insurance directories and found an “alarming proportion” were “unresponsive or unreachable.” Insurers were working faster to fix problems in their plans once they had been identified, the report said, but officials had not seen sufficient improvement overall.

The report also examined the enforcement and implementation of the federal Mental Health Parity and Addiction Equity Act, which requires health insurance plans to provide the same access to mental health care as they do to medical care. The agency is currently investigating the oversight and management of doctors hired by insurance companies who repeatedly deny mental health coverage for patients and may open additional investigations on the topic.

“[Conducting reviews of coverage is] supposed to be done with impartiality and without having been structured in such a way as to incentivize the physicians to favor denying claims as opposed to granting claims,” Timothy Hauser, a deputy assistant secretary of labor, said in an interview with ProPublica. “Similarly, the physicians and the providers should not be selected because of their propensity to deny claims.”

Editor’s note: To read ProPublica’s coverage of this story, click here. To read the Department of Labor report, click here.