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Monday, Aug 3 2015

Full Issue

When Insurers Deny Long-Term Mental Care Treatment, The Results Can Be Dangerous

CBS 60 Minutes investigates the battles that parents fight for psychiatric care for their kids. And KHN looks into the practice and enforcement of a landmark federal "parity" law that requires insurance providers to cover mental illness as they would any other disease.

Two years and a half years ago, we were reeling from the shock of the murders of 20 first graders and six educators at Sandy Hook Elementary School. Since then, we've learned that the killer suffered profound mental illness. His parents sought treatment but, at least once, their health insurance provider denied payment. Because of recurring tragedies and an epidemic of suicides, we've been investigating the battles that parents fight for psychiatric care. As we first reported in December, we found that the vast majority of claims are routine but the insurance industry aggressively reviews the cost of chronic cases. Long-term care is often denied by insurance company doctors who never see the patient. As a result, some seriously ill patients are discharged from hospitals over the objections of psychiatrists who warn that someone may die. (Pelley, Rey and Zill-de Granados, 8/2)

When Michael Kamins opened the letter from his insurer, he was enraged. His 20-year old son recently had been hospitalized twice with bipolar disorder and rescued from the brink of suicide, he said. Now, the insurer said he had improved and it was no longer medically necessary for the young man to see his psychiatrist two times a week. The company would pay for two visits per month. "There was steam coming out of my ears," Kamins recalled, his face reddening at the memory of that day in June 2012. "This is my kid鈥檚 life!" (Gold, 8/3)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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