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Report: Private Insurers Deny More Claims For Mental Health Care

The rate of denials by the state’s largest managed care insurers of requests for mental health services rose nearly 70 percent between 2013 and 2014, with an average of about one in 12 requests for prescribed treatment initially rejected, a new state report shows. At the same time, the proportion of enrollees in the largest managed care companies who received outpatient or emergency department care for mental health doubled, from an average of 9.4 percent in 2013 to 20.8 percent in 2014, according to an analysis of the 2015 Consumer Report Card on Health Insurance Carriers in Connecticut, issued by the state Insurance Department. The percentage of members who received inpatient mental health care also doubled, although it remained low, with most companies providing inpatient services for less than .5 percent of all enrollees. The rise in rejections by the state’s 10 largest indemnity managed care companies – private health insurers, not including Medicare or Medicaid — came as state officials focused on improving mental health outreach and treatment, in the wake of the Sandy Hook school shooting in December 2012. The managed care organizations include companies such as Aetna Life Insurance Co., Anthem Health Plans, CIGNA Health and Life Insurance Co., and UnitedHealthcare Insurance Co.

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State Aims To Eliminate Barriers To Medical Care For The Mentally Ill

People with severe mental illness die 25 years earlier than the general population and 68 percent of the mentally ill have at least one chronic physical health condition, studies show. They don’t receive the care they need because mentally ill people are often discriminated against by medical practitioners and their mental illness can make it difficult for them to be proactive about their care, according to several mental health professionals. Daniela Giordano, public policy director of National Alliance for Mental Illness of Connecticut, said the problem is often a lack of understanding of mental illness by some health care providers. Giordano said she knows of people with mental illness whose “thoughts and comments were dismissed” by medical providers who view these patients through “a different lens.”

A state project is addressing such barriers to necessary medical care faced by low-income mentally ill people. Under the program, called Behavioral Health Homes (BHH) and based in mental health facilities where people are already receiving outpatient services, staff members coordinate participants’ mental health and primary care.

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