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Anthem to reprocess mental health claims

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Anthem Health Plans Inc. has agreed to adjust its billing code and to reexamine about 28,000 claims for mental health services dating back to the start of 2013, according to the Connecticut Insurance Department.

The concession, announced April 24, came as a result of an Insurance Department investigation. The North Haven insurance company is still facing a civil lawsuit by mental health care providers and advocates, who claim that Anthem discriminates against mental health patients.

The reevaluation process is expected to produce about $400,000 in reimbursements for health providers, the Insurance Department said.

The department plans to monitor Anthem’s monthly claim reports going forward, but representatives at the American Psychiatric Association say they are skeptical the agreement will end discriminatory practices related to mental health patients.

Earlier this month, the APA along with two other Connecticut entities filed a lawsuit against Anthem and WellPoint Inc., alleging the companies’ coverage polices violated the Mental Health Parity and Addiction Equity Act.

“APA cannot assume that Anthem’s proposed solution complies with MHPAEA or that Anthem has ended its discrimination against those in need of mental health care and benefits that we alleged in our complaint,” James Scully, APA CEO, said in a statement. “(There are) many outstanding issues that need to be resolved before we can assure members and their patients that Anthem is not discriminating against mental health patients.”

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