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News and Highlights
NY Attorney General Finds Excellus Denied Claims for Inpatient Addiction Services at Seven Times the Rate of Other Services, Violating Parity Law
March 18, 2015 – NY Attorney General Eric T. Schneiderman today announced a settlement with Excellus Health Plan for wrongly denying addiction and mental health benefits to thousands of New Yorkers in violation of state and federal parity laws. The settlement requires Excellus—which is part of the Blue Cross Blue Shield Association and has 1.5 million members in upstate New York—to cover residential treatment for addiction and mental illness and overhaul its claims review process for these services. It also requires Excellus to provide notice of a new appeal right to 3,300 members whose claims for addiction and mental health services were previously denied. The new appeals could return up to $9 million to patients.
LAC Director and President Paul Samuels and Former U.S. Drug Czar and retired Army General Barry McCaffrey published an op-ed in The Hill last week calling on Congress to pass the Comprehensive Addiction and Recovery Act, or CARA.
New York Attorney General Finds ValueOptions Denied Claims for Addiction Services at Four Times the Rate of Other Services, Reaches Settlement Including $900,000 Fine
March 5, 2015 – New York Attorney General Eric T. Schneiderman today announced a settlement with Beacon Health Options (formerly known as ValueOptions) for wrongly denying addiction and mental health benefits to millions of New Yorkers in violation of state and federal parity laws. The settlement requires ValueOptions—which administers behavioral health benefits to 2.7 million New Yorkers and 45 million Americans—to overhaul its claims review process and pay a $900,000 penalty. The settlement against ValueOptions is the fourth reached by AG Schneiderman’s Health Care Bureau since last year, making AG Schneiderman’s office a national leader in enforcing the federal parity law.