Insurers Deny Benefits for Mental Illness

I received this post from the Mental Health Association of the Heartland, along with a request to circulate it widely:

Kansas law adopted in 2001 requires health insurance companies to cover up to 45 in-patient days and 45 outpatient visits on an annual basis for treatment of biologically-based mental illnesses. However, recent data from the top 10 health insurance providers, as reported by the Kansas Insurance Department (KID), reveal that policyholders typically receive an average of six in-patient days or outpatient visits regardless of diagnosis.

The 2006 Mental Health Parity Task Force of the Governor’s Mental Health Services Planning Council suggested that there must be a significant number of health insurance policy holders who have had one or more of the following experiences which have resulted in the denial of adequate, appropriate or timely treatment since the 2001 Mental Health Parity legislation:

• Denial of claims for treatment of mental illness
  
  
• Excessive co-pays or deductibles for mental health treatment
  
  
• Refusal to authorize an adequate number of in-patient days and/or outpatient visits
  
  
• Inability to obtain or understand the standards and rationale used to deny authorization of treatment by an insurer
  
  
• Insurers recommending that “difficult” cases be referred to law enforcement or public mental health services
  
  
• Other problems with authorization of treatment of a mental disorder

We want to hear from individual policy holders, group health care administrators and mental health providers who have experienced any of these problems. Please share with us your personal written and/or oral accounts of your experiences.


We will listen to your experiences and help you, as appropriate, to file a formal complaint with the Kansas Insurance Department. To initiate a complaint with the KID, you may click on the following link to their website: http://www.ksinsurance.org/consumers/complaint.htm.

You may also put your concerns in writing and address them to the KID using the following contact information:

Kansas Insurance Department
Attn: Consumer Assistance
420 SW 9th Street
Topeka, Kansas 66612-1678
Phone: (785) 296-3071
Toll-Free: 1-800-432-2484
TTY/TDD: 1-877-235-3151
www.ksinsurance.org

Please let us hear from you if decide to file a complaint with the KID. We are collecting this information to better understand how to help Kansans get the care and treatment they need.

Senate Bill 380 was introduced during the 2007 session of the Kansas Legislature to provide health insurance coverage for the treatment of mental illnesses that is equivalent to coverage for other illnesses. Equal coverage is known as parity. We are hopeful that the bill will be considered in the 2008 session.

The lack of parity in coverage for the treatment of mental illnesses is a major factor in the perpetuation of the stigma associated with mental illness and a clear barrier to accessing treatment and moving toward recovery.

Thank you for your assistance with this effort.

Rick Cagan
For the Kansas Mental Health Coalition

Rick Cagan, Executive Director
National Alliance on Mental Illness - NAMI Kansas
112 SW 6th Avenue
PO Box 675
Topeka, Kansas 66601
785-233-0755
785-233-4804 FAX
800-539-2660
rcagan@nami.org
www.namikansas.org