Albany Business Journal
Beacon Health Options, a behavioral health subcontractor, is paying a $900,000 penalty to New York under a settlement tied to improper denial of benefits, according to state Attorney General Eric Schneiderman.
That money is the latest in a series of settlements related to state officials’ investigation into how mental health issues are handled by New York insurers.
Prior settlements sought to refund about $37 million to people wrongly denied benefits, the attorney general’s report shows.
Under the latest settlement, Beacon Health Options, formerly known as ValueOptions, is required to pay the $900,000 penalty and reform its claims review process, the report shows. The settlement is connected to mental health parity laws, which essentially require coverage for mental health issues that is equal to other medical conditions.
The company emailed a statement saying it supports mental health parity efforts. “Value Options takes the necessary steps to ensure that our policies and procedures are in compliance with federal and state mental health parity laws and regulations,” the email states.
One of the prior agreements was reached with EmblemHealth Inc., a New York City-based insurer, which agreed to a settlement that could potentially refund more than $31 million to people wrongly denied benefits, the report shows.
That money involves the company’s 3.4 million members spread between Albany and Suffolk counties.
Since at least 2011, EmblemHealth, through its behavioral health subcontractor, Value Options, issued 64 percent more denials of coverage in behavioral health cases than in medical cases, the attorney general’s report shows.
The other separate but related agreement was reached with MVP Health Care, the Schenectady-based insurer. That settlement in 2014 could result in more than $6 million being returned to MVP members, the attorney general reports.
Here is the report from the attorney general’s office.