A.G. Underwood Releases Report Highlighting Office's Work Enforcing Mental Health Parity Laws, Protecting New Yorkers

News from the New York Attorney General's Office 

May 31, 2018

Attorney General’s Press Office / 212-416-8060


New Report Shows Health Care Bureau’s Mental Health Parity Investigations Have Helped Transform the Industry and Provided Over $2 Million in Restitution to Consumers

Since 2014 Start of AG’s Investigations, Consumer Complaints Have Dropped by 60%

Consumers Who Believe They’ve Been Treated Unfairly Should Contact AG’s Health Care Helpline

NEW YORK – To mark the end of Mental Health Month, Attorney General Barbara D. Underwood today released a report detailing the work of the office’s Health Care Bureau in enforcing state and federal mental health parity laws over the past five years — which have helped transform the industry and resulted in over $2 million in restitution to consumers. The report, “Mental Health Parity: Enforcement by the New York State Office of the Attorney General,” summarizes the results to date of the Attorney General’s Office’s industry-wide initiative to ensure that all New Yorkers have access to behavioral health services, such as substance abuse treatment — including the enforcement of eight national settlement agreements with seven health plans.

“Access to mental health services, including substance abuse treatment, is critical to New Yorkers’ health and wellbeing,” said Attorney General Underwood. “Our office is committed to enforcing mental health parity laws to increase this access for all New Yorkers.”

In 2013, after receiving consumer complaints regarding health plans’ coverage of behavioral health treatment, the New York Attorney General’s Office launched a mental health parity initiative and began investigations into various health plans. Since then, the office has entered into eight national settlement agreements with seven health plans, and has overseen the enforcement of these agreements: MVP, EmblemHealth, Beacon Health Options (formerly known as ValueOptions), Excellus, HealthNow, Anthem, and two settlements with Cigna. Four of the settlements required health plans to implement sweeping reforms in their administration of behavioral health benefits, in particular relating to medical management practices, coverage of residential treatment, and co-pays for outpatient treatment, and to submit regular compliance reports. Two of the settlements focused on coverage of particular services, and two more addressed the improper imposition of preauthorization requirements for medication-assisted treatment (“MAT”). 

Over the past four years, the Attorney General’s Office has vigilantly monitored the health plans’ compliance with these agreements, and the results – presented in this report – illustrate the degree to which these agreements have contributed to the transformation of the industry’s approach to behavioral health services. Some highlights include:

  • Plans are imposing fewer barriers to necessary mental health treatment:
    • Covering the continuum of care, including residential treatment.
    • More consumers are able to access needed mental health care.
    • Plans are denying care at a lower frequency than in previous years.
  • Plans reimbursed nearly 500 consumers over $2 million for their out-of-pocket costs for previously denied claims.
  • Plans paid a total of $3 million in penalties.
  • Plans are letting providers prescribe – without preauthorization – medication-assisted treatment for patients suffering with substance abuse disorder.

Significantly, since 2014 when the Health Care Bureau initiated its investigations, the number of consumer complaints to the Health Care Bureau Helpline regarding mental health and substance abuse issues diminished by nearly 60%.

Consumers who believe that they may have been treated unfairly by a health care provider, HMO or insurance plan, or health-related business, should contact the Attorney General’s Health Care Helpline by either calling the Helpline at 1-800-428-9071, or by submitting a complaint form online or by mail.

The Health Care Bureau is led by Bureau Chief Lisa Landau, together with Deputy Bureau Chief Susan J. Cameron. The Health Care Bureau is part of the Social Justice Division, which is led by Executive Deputy Attorney General Matthew Colangelo.