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ama-assn.org | Press Release | AMA asks Congress to hold insurers accountable for repeated failures

Feb 1, 2022

Source: Press Release; American Medical Association

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CHICAGO— With Congress holding hearings this week on the growing mental health crisis, the American Medical Association (AMA) is urging congressional leaders to take steps to address nearly 15 years of repeated failures by health insurance companies to comply with the landmark mental health and substance use disorder parity law.

The Senate HELP Committee and the House Ways and Means Committee are examining how to help patients with a mental illness given health plans’ repeated noncompliance. A recent report to Congress from the departments of Labor, Health and Human Services, and Treasury found that insurers’ parity violations have continued and become more serious since the law was enacted more than a decade ago. The report found widespread violations affecting patients with autism, eating disorders and substance use disorders — violations that led to delays and denials of care, patient harm, and likely avoidable deaths.

“This report underscores two simple facts: insurers will not change their behaviors without increased enforcement and accountability, and patients will continue to suffer until that happens,” according to the letter from AMA CEO James L. Madara, M.D.

The AMA agrees with many of the policy recommendations in the congressional report pertaining to the mental health parity law, including: 

  1. granting the Labor Department the authority to assess civil monetary penalties for parity violations and pursue noncompliance facilitated by third-party administrators
  2. enabling plan participants and beneficiaries to recover financial losses associated with improper claims denials stemming from violations of the law
  3. requiring plans to conduct prospective health benefit analyses for parity compliance, and
  4. permanently expanding access to telehealth.

Download a copy of the AMA’s full letter here.

Media Contact:

Jack Deutsch | ph: (202) 789-7442 | jack.deutsch@ama-assn.org

About the American Medical Association

The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.

SOURCE: https://www.ama-assn.org/press-center/press-releases/ama-asks-congress-hold-insurers-accountable-repeated-failures

Categories: National Headlines