Philip Seymour Hoffman 1967-2014

Serious mental health and addiction problems affect millions of Americans and when untreated lead to more suffering, costly medical treatment and social problems. These problems are found in individuals and families of all walks of life and at all ages. In addition, when untreated, these problems are often associated with serious accidents, injuries, suicide, disabilities, homelessness, lost jobs, divorce, child neglect, physical and sexual abuse, domestic violence, DWIs and other crimes.

A major issue, with people who experience major mental health and addiction problems, is that they often are impaired, to the extent that they don’t seek help early enough. Their problems are made significantly worse, when millions of people, who are seeking treatment and have paid for their insurance coverage, are denied access to treatment services.

NYS Investigates Claims of Insurer Discrimination

The NYS AG’s office has aggressively investigated health insurance companies operating in New York that have had long-standing complaints and discriminatory practices. These insurers sell policies to public and private employers and individual policies including Medicare Advantage plans that include mental health and addiction treatment benefits.

However, at the same time, they have restricted and denied coverage and claims as “not medically necessary” at substantially higher rates than other medical services. The AG investigations identified a number of common administrative deficiencies including inadequate compliance systems consistent with state and federal parity laws, rules, regulations and professional standards.

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