The U.S. Congress has enacted laws intended for Americans to get easy access to high-quality medical care, and the mandate applies to all cases – whether physical or behavioral. The Affordable Care Act (ACA) promises health coverage and assures that mental care gains due attention. Complementing the ACA is the Federal Parity Law or the Mental Health Parity and Addiction Equity Act (MHPAEA) that views all illnesses in equal stead.
These laws took effect in 2010, but Americans have yet to enjoy their benefits entirely. Mostly, health insurance companies employ creative tactics that allow them to earn big from government-subsidized health plans. But they also rigged the system to deny policyholders the coverage they paid for. Patients, many of them struggling with behavioral disorders, ended up getting the short end of the deal.
Insurers either held off making payments to these people or rejected their claims altogether. Such actions led to treatment centers losing their business and patients being forced out of treatment programs.
Not An Isolated Incident
A case in point was the sad fate that befell DeeDee Tillitt and her 21-year-old son Max. In 2016, Max was three weeks into his heroin addiction treatment, and specialists had wanted him to continue the program. But the insurer denied Tillitt’s request for further funding, leaving the mother no choice but to take her son home.
She made a painful decision that only ten weeks later turned tragic. Unable to cope with his condition, Max returned to substance abuse and died of an overdose. His death, DeeDee soon found out, was not an isolated case. Other families also encountered roadblocks in getting treatment for their ailing loved ones. Insurance companies made it difficult for them to claim the coverages they bought. For many, the standoff resulted in the loss of lives.
Months after the death of Max, DeeDee joined other victims seeking justice. Their collective fight is directed against erring firms like Centene Corp. and its California subsidiary Health Net. The objective is to right the wrong perpetrated by these giant corporations, who seemed callous on the suffering of thousands of Americans.
The Fiasco Involving Health Net
Specifically, Health Net is at the center of similar cases in California. The insurer has a record of bad business practice even before its 2016 merger with Centene. But the union made the two firms even bolder. Their decision to suspend and underpay treatment centers drove many of these facilities out of business in the same year. Consequently, thousands of patients were left without medical care, and there is no telling if the insurance coverages will ever be restored.
Health Net took advantage of the legal remedies available to them. The company carried out SIU audits that made life difficult for hundreds of behavioral treatment centers. Ironically, Health Net used lawful means to harass and intimidate, targeting care providers and helpless patients. And in the process, the company disregarded the provisions stipulated in the ACA and MHPAEA. This is the truth that DeeDee and thousands like her are seeking to expose.
