On the heels of a traumatic, COVID-ridden three years, overdoses have spiked, and substance abuse disorders are rising. And despite being federally required to cover mental healthcare at the same level as physical care, insurers are still putting up roadblocks for treatment.
According to a March 31st article in the New Canaan Advertiser, UnitedHealth Group, the nation’s largest health insurer is facing new fines over their coverage of substance use disorders—or, shall we say, lack thereof.
In Providence, Rhode Island, regulators are demanding $100,000 from UnitedHealthcare after discovering that the insurer refused to play by the rules, also known as the law, when determining substance use disorder coverage for individuals seeking treatment.
Upon review, UnitedHealthcare was found to improperly deny coverage in dozens of instances between 2015 and 2018. While UnitedHealthcare admits no wrongdoing, according to the article, the insurer has 90 days to “submit a corrective action plan to the state.”
If you’re apt to think it may have been an honest mistake, we’d advise against it.
This isn’t the first time this has happened. As recent as August of 2021, the insurer settled charges over its denial of both mental health and substance use disorder coverage in New York, and had to pay nearly $15.7 million in restitutions and fines for “imposing more restrictive limits on coverage and treatment for mental health and substance abuse disorders than it imposed for physical conditions.” Glad to know where the insurer stands on the matter!
The issue is that substance use and mental health disorders are on the rise dramatically, especially among children and teens. Just this December, the U.S. Surgeon General issued an advisory calling attention to the country’s youth mental health crisis.
Lives are at risk – and insurance companies are standing in the way.
This isn’t just a COVID-19 issue, either. The pandemic certainly exacerbated mental health issues, but the groundwork was already laid. By both outwardly failing to follow the rules, as well as just generally turning mental healthcare into an administrative nightmare, insurers continue to pay as little as legally possible while raking in premiums.
States like Rhode Island are doing the right thing by imposing fines, but $100,000 is chump change for a company poised to surpass $3 billion in revenue this year.
We have to ask; how many lives could have been changed – how many could have been saved – if some of that money had been put to good use?
