Kennedy Forum Shines Light on Need to Update Health Insurance Appeals System
Issue Brief Highlights Challenges Associated with Filing an Appeal based on A Behavioral Health Parity Violation

Washington, D.C. / PR Newswire / June 16, 2017 – The Kennedy Forum continues to drive change in behavioral health parity with the release of the latest issue brief: Filing An Appeal Based On A Parity Violation. The policy document offers recommendations to improve the health insurance appeals system by eliminating parity violations and reducing the systemic barriers patients face when appealing a denial of care.

“We are overdue to rethink and improve the existing health insurance appeals system, to make the appeals process more efficient, transparent and meaningful,” comments former Congressman Patrick J. Kennedy (D-R.I.) and founder of the Kennedy Forum. “A robust appeals system will bring parity to life by forcing health plans to be compliant and ensure those who inappropriately deny care are held accountable.”

The timing of the issue brief is critical as the federal government prepares additional guidance on parity. pursuant to the 21st Century CURES Act. Among other issues, the regulatory guidance must address the need to increase enforcement efforts to ensure that health plans are complying with the Federal Parity Law and applicable state laws. Part of those efforts must include improving the health insurance appeals systems.

The Federal Parity Law requires most U.S. health insurance plans to provide behavioral health coverage equal to the coverage offered in medical/surgical benefits. Yet, due to an antiquated, fragmented and broken healthcare payer system, far too many health plans are not compliant with this law – and worse yet, the health insurance appeals system for patients is failing us as well – often leaving those with behavioral health and substance use disorders to fend for themselves against well-resourced insurance companies in a proverbial “David vs. Goliath” battle.

The issue brief provides a roadmap to aid policymakers on the regulatory requirements and accreditation standards overseeing how appeals are handled. The succinct policy recommendations include calling for a nationally uniform, streamlined system; and it places special emphasis on increased consumer awareness of the health insurance appeals process, education on how to file an appeal, and greater transparency of the entire process.

Kennedy elaborates, “The time is now to have a serious public policy discussion both at the federal and state levels about improving the health insurance appeals system. These action steps are a necessary first step to ensure that patients and attending providers have full due process, especially as it relates to behavioral health treatment and services.”

To download the issue brief, Filing An Appeal Based On A Parity Violation, click here. For more information about the Kennedy Forum or other helpful resources addressing mental health and substance use, please visit www.TheKennedyForum.org.

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About the Kennedy Forum

Founded in 2013 by former Congressman Patrick J. Kennedy (D-R.I.), the Kennedy Forum focuses on advancing evidence-based practices, policies, and programming in behavioral health. This is achieved through promoting public discourse in health and addiction issues, ensuring equal access for patients living with mental health and/or substance use disorders; and advancing prevention and treatment throughout the entire continuum of the healthcare delivery system. The Kennedy Forum’s collaborative partnerships help to foster greater provider accountability, integration and coordination, cutting-edge technologies, and brain fitness and health. The nonprofit organization publishes frequent issue briefs and is a repository of other educational resources on behavioral health parity issues. To learn more about the Kennedy Forum’s efforts to eradicate the stigma often associated with behavioral health, or to access related materials visit www.thekennedyforum.org, www.paritytrack.org, and www.parityregistry.org.