AG Keith Ellison, Blue Cross And Blue Shield Reach Deal On Mental Health Access

AG Keith Ellison, Blue Cross And Blue Shield Reach Deal On Mental Health Access

Blue Cross also agreed to a stayed civil penalty of $300,000, which it will be required to pay if they are found by a court to have violated the terms of the settlement.

Minnesota Attorney General Keith Ellison announced a settlement with Blue Cross and Blue Shield of Minnesota on Friday that he says will make mental health care services more accessible to Minnesotans.

In June 2019, the Minnesota Attorney General’s Office began investigating Blue Cross’ compliance with Minnesota’s mental health parity laws. Under Minnesota law, a company may not impose treatment limitations that discriminate against mental health services in favor of physical health services.

The investigation found that Blue Cross may not have complied with these requirements, with the settlement also stating that its website may have been inaccurate because the AG's office received complaints that Blue Cross had denied coverage for medically necessary behavioral health services.

Blue Cross disputed these findings and maintained that it has always complied with the applicable statutes and regulations. Despite this, the company agreed to enter into a settlement that will require it to:

Make decisions for or at least 95% of prior authorization requests for behavioral health services within five days.

Approve or deny a behavioral health provider’s request to join Blue Cross’ network within 45 days.

Implement initiatives to increase behavioral healthcare access and provide data to the AG's Office to evaluate their success. This includes nonpublic trade secret information.

Pay a consultant selected by the AG's Office to review and advise the Office on the "Nonquantitative Treatment" to ensure BCBS is not imposing more restrictive limitations on mental health/substance use benefits than on medical/surgical benefits in the same classification.

Respond within 30 days to any complaint about behavioral health parity submitted to the AG's Office.

In addition to these terms, Blue Cross will voluntarily pay $600,000 to Minnesota State University-Mankato for use by its Center for Rural Behavioral Health.

Blue Cross also agreed to a stayed civil penalty of $300,000, which it will be required to pay if they are found by a court to have violated the terms of the settlement. The settlement lasts until December 31, 2028.

“Mental and behavioral healthcare is healthcare, period,” Attorney General Ellison said. “We expect someone with a broken leg to be able to get the care they need, and the same should be true of Minnesotans struggling with conditions like depression or substance use disorder. My mission is to help folks afford their lives and live with dignity, safety, and respect, and improving the people of Minnesota’s healthcare is fundamental to that mission.”

SOURCE: Bring Me The News