The New Hampshire Insurance Department found what it calls “a warning sign” during an investigation into whether insurance carriers in the state are following a federal law that requires insurers to cover mental health services as they would any other medical services.
Acting Insurance Commissioner Alex Feldvebel said a first-of-its-kind, 18-month review of insurance carriers offering plans on healthcare.gov in New Hampshire found that Anthem and Harvard Pilgrim are reimbursing providers for mental health services at lower rates than they do for other medical treatments.
The report stops short of accusing the companies of violating the Mental Health Parity and Addiction Equity Act of 2008. But Feldvebel said, “it constitutes a warning sign and it puts an obligation on the carrier to come forward with documentation about what their procedures and standards are for setting reimbursement rates.”
Both companies contest the finding.
In a written statement, a spokesperson for Anthem said the findings are the result of a flawed analysis. A Harvard Pilgrim spokesperson said the company “respectfully disagrees” with the finding.
Nonetheless both companies have entered into separate agreements with the Insurance Department to address the issue. Under those agreements, the companies will produce more detailed documentation of how they set their reimbursement levels, potentially validating their concerns with the state's findings.
“They could come up with documentation that would demonstrate that their procedures are comparable but for other reasons they ended up with a difference in the ultimate reimbursement rates,” said Feldvebel. “We don’t rule that out.”
The Insurance Department will present its findings to the Mental Health and Addiction Services Advisory Committee on February 14.