New York Attorney General took a major step forward in the enforcement of the Federal Parity Law in the states, issuing a landmark decision against an insurer in NY for violations of the parity law, one of the first such actions in the states. After an investigation into potential violations by MVP Health Care and Value Option, MVP’s managed behavioral health contractor, the New York Attorney General assessed MVP Health Care a civil fine and is requiring they bring their behavioral health coverage into compliance with the Mental Health Parity and Addiction Equity Act. MVP Health with also be subject to future monitoring of their insurance practices. The violations cited were both quantitative (more restrictive visit limits for behavioral health) and nonquantitative treatment limitations, including more restrictive utilization review and fail first requirements.
During the investigation, the Attorney General found that MVP Health Care issued more than 40% more denials for behavioral health conditions than for medical conditions. Advocates have been decrying these more restrictive authorization policies in many states since the release of the Interim Final Rule in 2010. Many are hopeful that this decision will force insurers to take more care in how they implement treatment limitations and assure they are in compliance with the federal parity law.
More specific conditions of the settlement and consumer examples of violations can be found in an article by Gary Enos in Behavioral Health Care.