US Representative Joe Kennedy III recently introduced an important bill, a bill that would force transparency guidelines upon insurance companies, a bill that would require insurance companies to disclose to federal regulators how often they deny mental health or substance abuse claims – as well as cite specific reasons for their denials, a bill that will finally provide confused and frustrated families with answers. A bill that could give us the tools necessary to fight for the insurance coverage to which we are entitled. A bill that could save lives.
It’s called the “American Psychiatric Association Practice Guidelines (which utilizes evidence-based recommendations for the assessment and treatment of psychiatric disorders), insurers create their own rules. They are not experts in eating disorders, they are not experts in effective treatment and recovery strategies, they are not experts in the latest research methods for eating disorder treatment; they are not experts in nutrition, therapy, or recovery. They are insurance companies – and they have a bottom line. The road back to health from an eating disorder is extensive, and its clear that insurance companies aren’t interested in covering that cost.
Insurers say that new legislation like this is not necessary, and they are already addressing the issue. The National Alliance on Mental Illness (a nonprofit advocacy group) says that evidence from its own national survey shows insurance companies deny authorizations for mental health care at more than twice the rate of general medical care, and that they use their own standards to decide what constitutes medical necessity. Furthermore, they are not accessible when it comes to informing patients of their standards.
Insurance companies have left us with no choice. They have literally put our families at risk, our health at risk, and our lives at risk while monopolizing the mental health treatment system and dictating our ability to access life-saving treatment.
Thanks to advocates like Kennedy, this bill could force insurers to be clear about their methods, clear about their denial rates and denial motives, and clear about the inner workings of their system. Essentially, this bill will keep them honest and lawful, and it will keep us protected from those unwarranted and unjustified obstacles to mental health treatment.
Come on insurance companies, stop dragging your feet. Families dealing with mental health crises do not have the time to jump through your bureaucratic hurdles.
Just tell us the truth.