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Delaware fines health insurers following mental health parity exams

Delaware Public Media

The Delaware Department of Insurance issues hundreds of thousands of dollars in fines to regulated health insurers for mental health discrimination.

The department conducted mental health parity examinations which ensure mental health substance abuse treatment are covered like any disease, injury or other reason to visit a doctor.

In the first series of examinations, the Department of Insurance uncovered thousands of violations resulting in $597,000 in fines so far.

The exams are ongoing, and include each of the four major insurers.

Insurance Commissioner Trinidad Navarro explains where people are facing the most difficulty.

"Prescription drugs with coverage for different types of treatment that is not on the same level and it should have been," said Navarro. "This is our first exam and we knew that there would be some problems, but we didn't know that we would find thousands of violations and it resulted in just under $600,000 in total fines so far. I will say the insurers have made some changes, and they are working with us."

Navarro notes the violations were found in policy and practice differences between mental health and medical and surgical procedures, medications, and procedure preauthorization requirements.

In those cases, mental health patients had to meet higher standards than other patients and pharmacy requirements were different as well. 

Navarro says mental health care is a critical issue made even more important by the pandemic.

"It's a real problem now more than ever because access and affordable mental health and substance abuse care, they've always been a priority for me, but with COVID-19 and the issues surrounding everything from kids not going to school and not having interaction, and feeling lonely and isolated it's more important now than ever before," said Navarro.

The exams are possible because of the passage of SB 230 in 2018 which required insurance companies to submit an initial analysis of mental and behavioral health coverage to the department in 2019. The department would then include compliance reviews in their annual market conduct exams.

Joe brings over 20 years of experience in news and radio to Delaware Public Media and the All Things Considered host position. He joined DPM in November 2019 as a reporter and fill-in ATC host after six years as a reporter and anchor at commercial radio stations in New Castle and Sussex Counties.