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orleans

(34,060 posts)
Sat May 25, 2019, 10:03 PM May 2019

"As Suicides Rise, Insurers Find Ways to Deny Mental Health Coverage"

"The U.S. is in the midst of a mental health crisis. In 2017, 47,000 Americans died by suicide and 70,000 from drug overdoses. And 17.3 million adults suffered at least one major depressive episode. The Mental Health Parity and Addiction Equity Act, a landmark law passed more than a decade ago, requires insurers to provide comparable coverage for mental health and medical treatments. Even so, insurers are denying claims, limiting coverage, and finding other ways to avoid complying with the law.

"Americans are taking to the courts to address what they see as an intrinsic unfairness. DeeDee Tillitt joined one lawsuit in 2016, months after she lost her son Max. He’d been an inpatient for three weeks at a treatment center to recover from a heroin addiction and seemed to be making progress. His addiction specialist wanted him to stay. United Behavioral Health, a unit of UnitedHealth Group, the nation’s largest insurer, declined to cover a longer stay for Max. Reluctantly, his family brought him home. Ten weeks later, Max was dead of an overdose. He was 21.

"Tillitt soon discovered that Max’s death wasn’t an isolated tragedy. Across the country, people who need mental health and addiction treatment encounter roadblocks to care that could save their lives. United Behavioral Health was already the target of a class action alleging that it improperly denied coverage for such treatment. UnitedHealth’s headquarters is in the Minneapolis suburbs, not far from where Tillitt lived. She says she spent hours on the phone getting passed from one rep to another in her quest to find Max care the insurer would cover. “I felt like, God, could I just drive down to the lobby and scream at them?’?” she says.

"Tillitt became part of the suit against the company in February 2016. In March of this year, a judge found United Behavioral Health liable for breaching fiduciary duty and denying benefits, saying the insurer considered its bottom line “as much or more” than the well-being of its members in developing coverage guidelines. United Behavioral Health says it’s changed its guidelines and that “our policies have and will continue to meet all regulations.” In May the company asked the court to decertify the class, which would mean only the named plaintiffs would be eligible for remedies."

~~more at link; worth the read~~

https://www.bloomberg.com/news/features/2019-05-16/insurance-covers-mental-health-but-good-luck-using-it

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"As Suicides Rise, Insurers Find Ways to Deny Mental Health Coverage" (Original Post) orleans May 2019 OP
Just another example of the total failure of the American Criminal Enterprise Healthcare System. democratisphere May 2019 #1
The system is screwed, for sure, but even Medicare has tight restrictions on what they will cover Hoyt May 2019 #2
the entire system needs to be orleans May 2019 #3

democratisphere

(17,235 posts)
1. Just another example of the total failure of the American Criminal Enterprise Healthcare System.
Sat May 25, 2019, 10:24 PM
May 2019

Time for single payer with stringent price controls.

 

Hoyt

(54,770 posts)
2. The system is screwed, for sure, but even Medicare has tight restrictions on what they will cover
Sat May 25, 2019, 11:22 PM
May 2019

regarding inpatient rehab. Medicaid is even more restrictive. Outpatient care is much less restrictive, but often not as effective. In any event, healthcare coverage aspect of this health problem is not likely to get better unless the patient pays for it, the government loosens its restrictions, or we all pay higher premiums.

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