Fines hold Illinois insurers accountable for equal coverage of mental health and addiction care | The Kennedy Forum

Fines hold Illinois insurers accountable for equal coverage of mental health and addiction care
July 17, 2020

Washington, D.C., July 17, 2020 – On Wednesday, July 15th, the Illinois Department of Insurance (IDOI) announced fines against five major insurance companies for violating the 2008 Mental Health Parity and Addiction Equity Act (Federal Parity Law), which requires health plans to cover treatment for mental health and substance use disorders no more restrictively than treatment for illnesses of the body, such as diabetes and cancer.

CIGNA Healthcare of IL, United Healthcare, CIGNA Health and Life, HCSC, and Celtic will pay a combined total of over $2 million for failing to use appropriate medical necessity criteria, unnecessarily requiring prior authorization for treatment, imposing step therapy, and failing to perform proper internal parity testing.

Parity enforcement is more critical than ever as Americans grapple with COVID-19 and subsequent economic and social turmoil, which are already contributing to increasing rates of anxiety and depression across the country. Additionally, new data recently released by the Centers for Disease Control and Prevention (CDC) show that drug deaths in America hit record numbers in 2019 and are steadily rising.

“The state of Illinois has once again stepped up to lead by example in righting a wrong that impacts countless families,” said former U.S. Rep. and lead author of the Federal Parity Law, Patrick J. Kennedy. “Access to affordable, in-network care is one of the most critical aspects of recovery from mental health and substance use disorders. Thank you, Governor Pritzker, for recognizing that, and for taking real action to make a difference.”

The Kennedy Forum Illinois, which leads ongoing efforts to improve enforcement of the Federal Parity Law in Illinois—and was critical to the enactment of Illinois’ 2018 state parity law—praised state leaders. “We appreciate the efforts of AG Kwame Raoul and Director Robert Muriel in holding health plans accountable for these egregious violations,” said Executive Director Cheryl Potts. “Every day, we work hard to ensure people have access to the treatment they need and deserve. Illegal and discriminatory acts by insurers must not stand in the way of progress.”

IDOI’s actions followed a January 2018 letter to The Kennedy Forum Illinois committing to launch parity examinations.

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About The Kennedy Forum

Founded in 2013 by former Congressman Patrick J. Kennedy (D-R.I.), The Kennedy Forum leads a national dialogue on transforming the health care system by uniting mental health advocates, business leaders, and government agencies around a common set of principles, including full implementation of the Federal Parity Law. Launched in celebration of the 50th anniversary of President Kennedy’s signing of the landmark Community Mental Health Act, the nonprofit aims to achieve health equity by advancing evidence-based practices, policies, and programming for the treatment of mental health and addiction. The Kennedy Forum’s “Don’t Deny Me” campaign educates consumers about their rights under the Federal Parity Law and connects them with essential appeals guidance and resources. To learn more about The Kennedy Forum and donate, please visit www.thekennedyforum.org.

For more information, please contact:

Amber McLaughlin
amber@thekennedyforum.org