From the article - The probe found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care, echoing the findings of a recent ProPublica investigation.
The U.S. Department of Labor found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care, findings that mirror a recent ProPublica investigation. Health plans, and the companies that administer them, have excluded key behavioral treatments, such as therapies for substance use and autism, and offered inadequate networks of mental health providers, according to a 142-page report released Jan. 17 in conjunction with the Treasury and Health and Human Services departments. Please read the entire story here: https://www.propublica.org/article/department-labor-investigation-health-insurance-doctors-healthcare
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What’s more, that confusion and frustration might be intentional. A physician employed by the health insurance company Elevance once told me, “We have productivity metrics. We probably have 10 or 15 minutes or so to do reviews and depending on the case, that may not be adequate. And we’re told denying things is OK because people can appeal.” The problem is that these appeals impose substantial costs on patients, many of whom don’t ultimately get their prescribed treatments. Read the entire article at the link - https://www.statnews.com/2025/01/23/health-insurance-denial-prior-authorization-help-appeal/ |
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