Thursday, June 2, 2011

Denying Residential Treatment is a Violation of Federal Law

EDC Takes a Stand: Denying Residential Treatment is a Violation of the Federal Parity Law

In February of this year the EDC launched the Hold Insurance Companies Accountable Campaign as a response to a number of insurance companies that are categorically denying residential treatment for eating disorders.

Yet parity experts agree that individuals are entitled to receive such treatment under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-343).

The Act requires that any group health plan that includes mental health and substance use disorder benefits along with standard medical and surgical coverage must treat them equally. According to the nationally recognized law firm of Patton Boggs, the statute is clear that limits on the scope and duration of treatment must be applied no more restrictively in the mental health benefit than in the medical/surgical benefit. The statute defines treatment limitations as “limits on the frequency of treatment, number of visits, days of coverage, or other similar limits on the scope or duration of treatment.”

The EDC finds it insulting that some insurance companies are responding to federal legislation that was designed to provide consumers with more access to care - by providing less!

Not complying with the parity regulations is a calculated effort to avoid costs at the expense of people's health and lives. The EDC argues that treatment should be determined by severity and type of illness, rather than what is arbitrarily allowed by an individual’s insurance company.

The EDC's Hold Insurance Companies Accountable Campaign is working with families, specialized attorneys such as Lisa Kantor, and experts in the field to put an end to such discriminatory and deadly practices through legal and political advocacy.

WHAT CAN YOU DO?

We have heard from many people who have been denied insurance coverage for residential treatment - yet we need to hear from hundreds more!

If you have been denied insurance coverage for residential treatment email us at: EDCHoldsInsuranceAccountable@yahoo.com


Together we can and will make a difference.




Jeanine Cogan, Ph.D.
Policy Director
Eating Disorders Coalition
www.eatingdisorderscoalition.org
202-352-3208

3 comments:

kaylinjeanette said...

Insurance companies NEED to cover more when it comes to treatment for eating disorders. Eating disorders are at the very bottom when it comes to mental health. My question is why? Is it because it involves food as the vice and not alcohol or drugs? I hate to tell those insurance companies but eating disorders are extremely deadly and for some, food is like a drug. Millions are being affected. Thousands are dying and many of them are because they haven't received proper treatment or are unable to receive any. This hits very close to home for me as I battled anorexia for 16 years. I am 22 now. I lost 2 friends to it who were 17 and 19. Those could have been prevented with proper treatment. But, because so many insurance companies STILL refuse to pay, only pay the bare minimum or deny coverage for residential treatments the numbers continue to rise. Why are eating disorders discriminated against? Something needs to be changed and it ought to start with the policy that insurance companies attach to treating eating disorders. If it were a loved one of theirs, they would be outraged if they were denied coverage.

kaylinjeanette said...

Insurance companies NEED to cover more when it comes to treatment for eating disorders. Eating disorders are at the very bottom when it comes to mental health. My question is why? Is it because it involves food as the vice and not alcohol or drugs? I hate to tell those insurance companies but eating disorders are extremely deadly and for some, food is like a drug. Millions are being affected. Thousands are dying and many of them are because they haven't received proper treatment or are unable to receive any. This hits very close to home for me as I battled anorexia for 16 years. I am 22 now. I lost 2 friends to it who were 17 and 19. Those could have been prevented with proper treatment. But, because so many insurance companies STILL refuse to pay, only pay the bare minimum or deny coverage for residential treatments the numbers continue to rise. Why are eating disorders discriminated against? Something needs to be changed and it ought to start with the policy that insurance companies attach to treating eating disorders. If it were a loved one of theirs, they would be outraged if they were denied coverage.

Little Lyric said...

What do you do if the residential treatment centers won't even talk to you because of your insurance. I'm not denied by my insurance company; I'm denied by the treatment facilities themselves who will not consider taking Medicare/Medicaid. At this point in my eating disorder, I'm functional, so I don't "need" it in order to survive physically (at least, I hope not), but I will never be free from it without the ability to separate myself from the eating disorder (my bulimia) and live without it for an extended period of time. In the meantime, the quality of my life is about half or less of what is considered "normal" (in my own subjective judgment - I have very little idea of what constitutes normality).

I don't understand why the government will pay me thousands of dollars over the years to be on disability, when just one all-out attack on my eating disorder could possibly, just possibly put an end to my need for the disability entirely. I have such a desire to change that I would make the most of any opportunity given. But then again, Medicare and Medicaid have not even been given the chance to deny me. I have no money because of my eating disorder and all the impulsive poor judgments associated with it. Yet money is the only thing that will give me that one chance.

My eating disorder has not killed me. I do not feel in immediate danger of dying. Yet, I feel as if the eating disorder has killed my relevance as a person. I will not contribute like I could without the eating disorder. I will drain the people and resources around me. I have been denied the chance to fully heal and therefore gain meaning from any of my pain. This struggle so far has been pointless because I cannot win (get better) and I cannot lose (die). I live in an ever-present purgatory.

I want to advocate for parity, for eating disorder awareness and treatment, but in the end, does any of it even apply to my situation? In the end, am I just destined to be forgotten, no way out, not even any literature or guidebook as to what to do in my situation?

Sorry to be a downer. The advocacy IS worthwhile, and I DO support it and will do my best. I just wish there was some way I could do a bit more. You know, come out on top and help a bit rather than just sit here in need of helping.