In a significant crackdown on dubious practices in mental health care coverage, New York's Attorney General Letitia James has nailed down an agreement with MVP Health Plan. The settlement is the progeny of an investigation that exposed the health provider's faulty mental health directory, leaving members high and dry—some without care, others forking out extra for out-of-network services. According to the Office of the Attorney General, the insurer's listed mental health providers were as good as ghosts, with 100 percent failing to take new patients or even being reachable.
Under the terms laid out by AG James, MVP Health Plan will now have to shoulder financial restitution for members left paying more since January 1, 2020, because of this mess. Members eligible for restitution, which an OAG-approved compliance administrator will oversee, will be notified by MVP, as stated in their agreement. Let's not forget the $250,000 fine in penalties, fees and administrative costs being paid to the state. In a sweeping transformation, MVP is also required to ensure their provider directory is a reflection of reality—accurately listing practitioners who are indeed available and accepting new patients.
Turning a critical eye to the settlement details, MVP must contact every provider in its network every 90 days to confirm their availability and participation. The compliance administrator will monitor MVP's adherence to these reforms for a minimum of two years, conducting audits and evaluating member access to care as well as network adequacy standards. MVP also pledges to pour resources into beefing up its mental health network—this could mean more psychiatrists for younger patients, streamlining processes for providers, or helping members navigate mental health services.
The National Alliance on Mental Illness of New York State weighed in with hearty approval. "NAMI New York State wholeheartedly supports the Attorney General’s action to reform insurer provider networks, because there is no Health Care without Mental Health Care," Nathan McLaughlin, Executive Director of NAMI New York, said in a statement obtained by the Office of the Attorney General. On the enforcement front, Glenn Liebman, CEO of Mental Health Association in New York State, praised AG James for her leadership, highlighting that tough enforcement is crucial—marking the 20th anniversary of New York's Timothy’s Law, which called for mental health insurance parity, as per the Office of the Attorney General.
