Today, Jan. 15, the health insurance giant, Cigna, reached a settlement on its wrongful denials of mental health treatment compensation. The settlement will result in Cigna paying hundreds of claims that will compensate those denied for nutritional counseling for mental health disorders, such as eating disorders.
This settlement found its roots in 2010 when New York Attorney General Eric Schneiderman became privy to a complaint from a family whose daughter, diagnosed with anorexia nervosa, was denied coverage for a dietitian. Because of this denial, the family had to pay $2,400 out of pocket to support the nutritional component of her recovery, a crucial component. The 14 year-old had by that time developed osteopenia and her weekly visits to a dietitian were the main reason that her weight stabilized and she was able to create appropriate meal plans to re-nourish her body.
However, this claim of wrongful denial was only one of hundreds that surfaced in the following months from individuals prevented from receiving nutritional support for mental disorders by lack of insurance coverage. In addition to the enforcement of the national Mental Health Parity and Addiction Equity Act of 2008, the state of New York also has a law, Timothy's Law, that mandates "broad-based coverage for the diagnosis and treatment of mental, nervous, or emotional disorders or ailments ... at least equal to coverage provided for other health conditions."
Based on both of these protections, the Kantor & Kantor law firm, which specializes in prosecuting claims against insurance companies, reached a settlement with Cigna that would act as recompense to those denied coverage. As part of that settlement, Cigna must eliminate the three-fist cap for mental health conditions and reimburse those who had to pay out-of-pocket for nutritional support, costing the company an estimated $33,000.
Cigna is also responsible for completing in-service training with its staff to ensure that everyone is aware that there are no longer visit limits for nutritional counseling prescribed for mental health conditions. A civil penalty of $23,000 is also due to the Office of the Attorney General. For an insurance giant like Cigna, these financial penalties are no more than a drop in their well of resources; however, the settlement alone and the awareness it brings to this issue provides a precedence for enforcing the mental health parity act, especially with respect to eating disorders.
For those who are suffering from eating disorders, have suffered, or families and friends watching their loved ones struggle, this settlement is an enormous victory, validating the need for nutritional counseling in eating disorder treatment and upholding the vision of mental health parity.