In
Copyright Since September 11,
2000
HealthPartners said Wednesday that it will allow an outside panel to review all its denials of mental health care, under an agreement it reached with Minnesota Attorney General Mike Hatch.
The mental health appeals
committee was established last June as part
of Hatch's settlement with Blue Cross and Blue Shield of Minnesota,
which Hatch sued for improperly denying mental health, chemical
dependency and eating-disorder treatment.
"We feel this is a very creative process that helps to insure that policyholders will get the medically necessary treatment they deserve," said Al Gilbert, deputy attorney general.
Although HealthPartners' finances are being reviewed by the attorney general as part of his industrywide examination of administrative costs, HealthPartners mental health care was not being investigated by Hatch's office.
When Hatch settled with Blue Cross, he invited all health plans to participate in the appeals committee. For those health plans that participate, any mental health or related denial of care automatically will be forwarded to the committee, which has the power to overrule the health plan.
Ramsey County district judges Larry Cohen and Charles Flinn and Hennepin County District Judge Roberta Levy announced last month that they will step down from the bench to join the appeals committee, which should begin hearing cases next year.
"We feel this is a very creative process that helps to insure that policyholders will get the medically necessary treatment they deserve," said Al Gilbert, deputy attorney general.
Although HealthPartners' finances are being reviewed by the attorney general as part of his industrywide examination of administrative costs, HealthPartners mental health care was not being investigated by Hatch's office.
When Hatch settled with Blue Cross, he invited all health plans to participate in the appeals committee. For those health plans that participate, any mental health or related denial of care automatically will be forwarded to the committee, which has the power to overrule the health plan.
Ramsey County district judges Larry Cohen and Charles Flinn and Hennepin County District Judge Roberta Levy announced last month that they will step down from the bench to join the appeals committee, which should begin hearing cases next year.
"We've looked at the three judges and said these are good people and we
are comfortable with this group," said George Halvorson,
chief executive of HealthPartners.
Halvorson said he doesn't expect that many cases will be reviewed by the appeals committee because the Bloomington-based health plan has overhauled many of its mental health treatment policies, removing several prior authorization restrictions and referral rules.
Sandra Meicher, executive director of the Mental Health Association of Minnesota, said the appeals committee is a reasonable solution to overcoming the barriers created by health plans.
"Accessing services under a health plan should be easy," she said. The panel, which will review all denials within 24 hours, will help eliminate barriers, she said.
"It will make it easier to get services, easier to resolve access, easier to resolve grievances. It's a good investment," she said.
Gilbert said the attorney general's office is talking with Medica to see whether they also will use the appeals committee.
"We have every expectation that they will participate," he said.
HealthPartners also agreed to pay $2 million to the Minnesota Department of Human Services for mental health care care given to HealthPartners members. The department had billed HealthPartners for the care, much of which was provided at the state's regional treatment centers, but the health plan denied the claims.
.
- Staff writer Josephine Marcotty contributed to this report.
- Glenn Howatt is at howatt@startribune.com.
Halvorson said he doesn't expect that many cases will be reviewed by the appeals committee because the Bloomington-based health plan has overhauled many of its mental health treatment policies, removing several prior authorization restrictions and referral rules.
Sandra Meicher, executive director of the Mental Health Association of Minnesota, said the appeals committee is a reasonable solution to overcoming the barriers created by health plans.
"Accessing services under a health plan should be easy," she said. The panel, which will review all denials within 24 hours, will help eliminate barriers, she said.
"It will make it easier to get services, easier to resolve access, easier to resolve grievances. It's a good investment," she said.
Gilbert said the attorney general's office is talking with Medica to see whether they also will use the appeals committee.
"We have every expectation that they will participate," he said.
HealthPartners also agreed to pay $2 million to the Minnesota Department of Human Services for mental health care care given to HealthPartners members. The department had billed HealthPartners for the care, much of which was provided at the state's regional treatment centers, but the health plan denied the claims.
.
- Staff writer Josephine Marcotty contributed to this report.
- Glenn Howatt is at howatt@startribune.com.