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