CT Fighting Insurers Over Mental Health, Addiction Help

HARTFORD — Connecticut has joined a legal battle over how and whether medical insurers can deny coverage for mental health and substance abuse treatment.

Attorney General William Tong joined attorneys general from Rhode Island and Illinois Monday in filing an amicus brief in the United States Court of Appeals for the Ninth Circuit seeking to protect mental health and substance abuse disorder care in Connecticut, Rhode Island and Illinois.

The filing was announced at a press conference Monday featuring former Rhode Island Congressman Patrick J. Kennedy, lead author of the 2008 Mental Health Parity and Addiction Equity Act.

In their brief, the states argue in support of a petition for a full court review of the Ninth Circuit’s recent ruling to overturn Wit v. United Behavioral Health (UBH), the landmark case that in 2019 found the nation’s largest managed behavioral health care company wrongfully denied mental health and addiction treatment coverage to tens of thousands of subscribers.

“Mental health parity laws mean nothing if insurers can deny substance use disorder claims for baseless and arbitrary reasons. That’s why Connecticut’s law requires insurers to use criteria developed by addiction medicine professionals in their coverage determinations. The district court ruling in Wit v. United Behavioral Health would allow insurers to ignore Connecticut law and render meaningless our state’s mental health parity law. We are losing lives every day to opioid overdose and substance use disorders, and we cannot allow insurers to stand in the way of life saving care,” said Tong.

Under the laws of Connecticut, Rhode Island and Illinois, a health insurance company can only limit treatment for substance-use disorders in accordance with industry-standard medical criteria, known as the ASAM (American Society for Addiction Medicine) Criteria.

In 2019, the trial court in Wit found that UBH had violated state laws by using its own, more restrictive criteria to wrongfully deny mental health and addiction treatment coverage to tens of thousands of subscribers.

In March of this year, that ruling was overturned, setting what Tong said was a dangerous precedent for how treatment can be covered nationwide.

“We are on the cusp of major change when it comes to mental health and addiction treatment in this country,” said Kennedy. “No longer will we accept subpar coverage from our insurers for behavioral challenges that dramatically impact health and well-being.”