Lawsuit challenges insurance practices
Tuesday, March 2nd, 2010
New Jersey psychologists are suing two insurance companies and a state agency, claiming they're asking for intimate details about their patients' lives.
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The suit claims the insurance providers for New Jersey's 800,000 state employees ask for too much information before authorizing treatments for mental health issues. Named in the suit are the New Jersey State Health Benefits Commission, Horizon Healthcare Services, and Magellan Health Services.
Dr. Barry Helfmann of the New Jersey Psychological Association says insurers are asking for information that is private and protected by law:
Helfmann: If this particular patient were having marital problems, or maybe this patient was drinking too much, or taking other medications that were not necessarily prescribed.
Helfmann says the insurers' demands make patients anxious that intimate details about their lives are going beyond the treatment room. He says many state employees are worried about professional ramifications.
Helfmann: I have seen many police officers in my practice, and if they have anxiety over something they certainly don't want that to become public information because they are worried about being taken off duty.
In a joint statement, Magellan and Horizon say the information they request is appropriate and consistent with federal and state laws. They add that they respect the privacy of their members.
Additionally, "New Jersey's State Health Benefits Commission voted 3-2 to request the waiver from federal parity rules, as it has for the past decade."
"State workers and school employees will instead be covered under New Jersey's mental health parity rules, which only require equal coverage for so-called "biologically based" mental illnesses such as depression, schizophrenia and autism. For insured state workers, treatment for illnesses like eating disorders is subject to an annual limit of $15,000 and a lifetime limit of $50,000."
Courier Post 2/14/10