Incorrect judgment jeopardizes the psychiatric care of CT patients


At a time when more than 28 percent of Connecticut adults are reporting symptoms of anxiety or depression — up from 19 percent just two years earlier — the nation’s largest insurer is threatening to cut off access to much-needed mental health care. The present judgment in Wit v. United Behavioral Health encourages insurers to choose coverage for acute care rather than determining coverage based on generally accepted standards of care and denies individuals access to the long-term care they need.

Our state and nation are in the midst of a dire mental health crisis, which is being exacerbated by the pandemic and has prompted record numbers of people to seek medical care. At Mental Health Connecticut, we advocate and educate Connecticut residents and their communities about the importance of mental health, connect individuals with support services, and equip communities with the tools they need to care for their loved ones.

In our work, we often encounter individuals who are struggling to access the mental health care they need. We hear stories upon stories of people being denied care because their insurers use their own standards to determine medical necessity, rather than evidence-based standards developed by medical professionals. These dynamics impede access to mental health care within a system that is difficult to navigate for many other reasons.

A March 5, 2019 court ruling found United Behavioral Health to have violated the Mental Health Parity and Addiction Equity Act of 2008. This federal parity law requires equal treatment of mentally ill and addicted people by insurance companies. In March, however, a three-judge panel of the 9th Circuit Court of Appeals overturned the district court’s order in a seven-page judgment, arguing that it was “not unreasonable” for insurers to determine coverage in conflict with generally accepted standards of care.

The discrepancy between the district court’s solid and comprehensive 100-plus page decision and the superficial, seven-page reversal in Wit v. United Behavioral Health is unscrupulous. The current ruling will encourage insurers to make decisions that do not keep up with clinical standards. The impact of this case will be felt not just in Connecticut but across the country.

As of May, Connecticut has been one of four states (along with Rhode Island, Illinois and California) that have filed amicus briefs urging that this reversal be lifted. The Connecticut prosecution is led by Attorney General William Tong, who said, “It makes no sense for insurance companies to prioritize profits over people and stand in the way of treatment and prevention in the face of America’s worst public health crisis.”

In March, MHC joined 12 other Connecticut-based organizations in a letter supporting Tong’s amicus brief. MHC and our allies are grateful for Tong’s support and are committed to raising awareness of the devastating consequences of the current Wit verdict.

The current Wit ruling is at odds with the mission of Mental Health Connecticut and further complicates the work of our partner network. Connecticut residents deserve consistent, reliable access to the care they need to thrive and heal — and insurance coverage should be the last barrier in their search for services to help them feel healthy and well.

The real ramifications of Wit v. UBH affect far more than the 50,000 plaintiffs and thousands of Connecticut residents with mental illness. The current Wit ruling sets a national precedent that insurers, rather than medical experts, can dictate what level of care should be covered for mentally ill patients. We beseech the Ninth Circuit Court of Appeals to defend patients’ right to access safe, consistent care and allow an en banc review of this case.

Luis B. Perez is President and CEO of Mental Health Connecticut.


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