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AG finds BlueShield illegally denied claims for mental, nutritional counseling

Aug 23, 2016 12:02 am

Claire Hughes is reporting in the Times Union BlueShield of Northeastern New York and two related organizations wrongfully denied $1.6 million in claims for psychotherapy and nutritional counseling, according to the office of state Attorney General Eric Schneiderman. Denial of those claims was in direction violation of state and federal laws. Under a settlement with the state, BlueShield parent HealthNow New York, based in Buffalo, will pay a $60,000 fine, reimburse members for thousands of wrongfully denied claims and revise its practices. "Individuals confronting mental health conditions, eating disorders, or substance abuse should not be denied coverage for the treatment they need and deserve," Schneiderman said. The company covers about 573,700 New Yorkers. A decade-old state law known as Timothy's Law requires mental health and substance abuse coverage to be on par with coverage for medical issues, and a similar federal mental health parity law has been in effect since 2008. Read the full story in the Times Union.

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