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Post date: February 26 2004

Report Highlights Insurance Problems Faced By Eating Disorder Patients

Attorney General Spitzer today released a report highlighting health care coverage challenges faced by patients suffering from eating disorders. The report also provides tips that consumer may use to maximize their coverage.

The two primary problems reported by those with eating disorders are inadequate coverage for mental health care offered by their insurance plans and insurance plans denying treatment as no longer medically necessary (and therefore no longer covered) well before the patient's treatment is complete. The report was released during National Eating Disorder Awareness Week, February 22-29.

"People suffering from eating disorders are often victims twice - once by the condition itself, and then a second time by a health insurance system that may not adequately handle these complex and misunderstood disorders," Attorney General Spitzer said. "When coverage is denied or exhausted, patients are left with the difficult choice of paying for expensive care out-of-pocket or abandoning necessary treatment."

The report - - Focus On: Eating Disorders - - notes that current state law allows health care plans to set much lower caps on coverage for mental health care than for physical health care. For example, most policies have a 30-day limit for inpatient psychiatric care compared to 90 days or longer for physical care. Coverage is frequently exhausted because, although patients with eating disorders receive treatment for both physical and mental health problems, health plans may apply the lower mental health caps on all such treatment.

Spitzer's report contains a series of tips for consumers to use in order to maximize coverage for mental health care. For example, Spitzer advises that consumers should appeal denials of care that their doctor believes is medically necessary. While a low percentage of people appeal denials of coverage most of those who do win additional coverage.

More than 5 million Americans suffer from eating disorders such as anorexia. bulimia and binge-eating disorder. Anorexia is also among the deadliest psychological disorders, with a mortality rate of nearly 6% - - 12 times the average mortality rate for all causes of death among females ages 15-24. Overall, 85-95% of eating disorder victims are adolescent girls.

Focus On: Eating Disorders is the first in a series of periodic reports that the Attorney General's Office will issue documenting specific problems that consumers face in the health care system. The reports will also offer consumer tips. This edition of Focus On was written primarily by Assistant Attorney General Paul Beyer of the Health Care Bureau.

Consumers and providers with questions or concerns about health care matters can call the Attorney General's Health Care Bureau Hotline at 1-800-771-7755 (option 3). The full text of the report is available on the Attorney General's website:


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