Attorneys General in Connecticut and Rhode Island threw their support Monday behind a coalition of mental health advocacy groups asking a federal appeals court to revisit a recent ruling giving insurance companies more flexibility to deny mental health claims.
In late March, a three-judge panel in the California-based 9th U.S. Court of Appeals reversed a 2019 decision in the mental health parity case, Wit v. United Behavioral Health. The appellate panel had initially found that United had wrongly denied thousands of claims by patients seeking mental health treatment. The panel changed course and found it reasonable for insurance companies to set their own guidelines for which treatments are medically necessary.
On Monday, Attorney General William Tong joined his Rhode Island counterpart, Peter Neronha, and former U.S. Rep. Patrick Kennedy, D-Rhode Island, for a remote press conference to announce their amicus brief calling on the court to revisit the ruling.
Tong said the decision was especially damaging given the number of people across the country struggling with substance abuse problems exacerbated by the ongoing opioid crisis.
“It makes no sense, when facing the worst public health crisis in America, for insurance companies to prioritize profits over people and to stand in the way of treatment and prevention,” Tong said.
Neronha said the implications of the panel’s ruling could have consequences that are not limited to United policyholders and ignored mental health parity laws adopted in Connecticut and Rhode Island.
“What this is about is whether or not insurance companies, whether it be United or anybody else, have to apply … generally accepted standards of medical care in making decisions about what’s covered by insurance and what is not,” Neronha said. “Rhode Islanders in this case, were denied treatment by United, notwithstanding that the doctors and professionals said that was what was medically necessary.”
If the panel’s ruling stands, Tong said it could threaten the long term safety of thousands in Connecticut who suffer from substance abuse disorder and other mental health issues.
“These are not academic legal issues,” Tong said. “This is not some case in California that concerns really technical issues in the law. This is about people in Connecticut and Rhode Island who are suffering, who need treatment.”
Suzi Craig, chief strategy officer at Mental Health Connecticut, said insurance company efforts to deny mental health treatment claims were misguided.
“What’s been proven is that if they pay for the treatment up front in a preventative way with preventative measures, it saves them money down the road,” Craig said.
In a statement, Maria Gordon Shydlo, a spokesperson for UnitedHealthcare, said the insurance provider was committed to honoring its policies and complying with state and federal rules.
“We are committed to ensuring all our members have access to mental health care consistent with the terms of their health plan and in compliance with state and federal rules,” Shydlo said. “As part of our broader commitment to quality care, we continue to support our members with increased access to providers and new ways to quickly get the effective behavioral support they need.”