On May 13, 2015, the Missouri State House of Representatives passed Senate Bill 145 (SB 145) requiring insurance companies to provide proper diagnosis and treatment for eating disorders. After seven years of much effort, dedication, and advocacy, the legislation finally passed and remains in the hands of Governor Jay Nixon for approval. The new legislation would require insurance companies to make any necessary changes to health plans before coverage begins for the year 2017.
Although the state of Missouri must comply with Mental Health Parity laws, insurers continue to interpret the unclear language to their advantage – finding loopholes and evading semantics of the law to deny treatment. Unfortunately, parity violations and insurance denials for the treatment of eating disorders are incredibly common, not just in Missouri, but across the nation.
SB 145, if signed by Governor Nixon, will require health benefit plans to cover the diagnosis and treatment of eating disorders in Missouri. This legislation provides clear guidelines for insurance companies to utilize when approving or denying coverage for eating disorder treatment. By defining guidelines for specific standards of care, insurance companies should be less likely to get away with denying eating disorder treatment. Furthermore, this legislation states that medical necessity for eating disorder treatment should not be based upon an individual's weight, but should also consider their overall physical and medical needs. Weight restoration is only one piece of the recovery journey.
The work, progress, and efforts in the eating disorder community often come from those who have personally been affected by eating disorders. In this case, eating disorder advocate Annie Seal (Board President of NEDA Network member MOEDA), has been the driving force and determination behind SB 145. Annie's daughter recovered from an eating disorder, but not without a battle from their insurance company. With a profound motivation to make change, Annie continues to tirelessly advocate for insurance reform on behalf of all families who will face this gross injustice.
While supporting her daughter's recovery was incredibly complicated and stressful, trying to make their insurance company pay was even worse. All around her, she watched those suffering from eating disorders deteriorate from insufficient treatment. Annie recalls, "I remember thinking, why are we focusing on insurance? Why can't we focus on getting our children well, or how to take care of our other children or each other?" To read Annie's story, click here.
SB 145 is a significant step forward for those in Missouri, as well as for the eating disorder community as a whole. The tireless efforts of many dedicated (STAR) advocates and sponsors has supported this important initiative, and paved the way towards parity enforcement and eating disorder awareness across the country.
If your insurance company has denied coverage for the treatment of your eating disorder, do not give up here! It is this silence that allows insurance companies to continue on with parity violations and unfair insurance denials. We encourage you to use your voice to challenge insurers, advocate for justice, and demand change.
For eating disorder legal assistance, contact our office for a free consultation.
We understand, and we can help.
www.kantorlaw.net (800) 446-7529