Buffalo insurer ordered to provide coverage

Posted at 8:12 AM, Aug 22, 2016
and last updated 2016-08-23 08:08:29-04

New York's attorney general has reached a settlement requiring a Buffalo-based insurer to pay thousands of improperly denied claims for outpatient psychotherapy and nutritional counseling for eating disorders.

Attorney General Eric Schneiderman says investigators found more than $1.6 million in wrongful insurance denials by HealthNow, New York Inc., which covers more than 573,000 New Yorkers.

Schneiderman says insurers have legal obligations to provide the same level of care for behavioral problems as other ailments.

An investigation of HealthNow followed consumer complaints.

In the settlement, HealthNow, without admitting the findings, agreed to pay a $60,000 penalty and stop requiring outpatient behavioral health visits be preauthorized after 20 visits annually and excluding nutritional counseling for eating disorders. It will notify more than 3,100 members they can resubmit such unpaid claims since 2012.