Advancing Access: Parity and Payment for Quality Mental Healthcare
The Austen Riggs Center presents the work of the Psychotherapy Action Network (PsiAN). This moderated panel discussion focused on helping therapists address insurance denials, violations of parity, and other treatment limitations that impact providing optimal care for our patients. The landmark Wit v UBH class action lawsuit represented a huge win for patients, therapists, and depth therapy. However, that lawsuit is now in peril, and insurance companies continue to violate parity laws and essentially ration care, which particularly impacts the provision of depth therapy.
In this recorded webinar, panelists with a range of expertise in the areas of insurance law and mental health advocacy spoke to:
The insurance advocacy tool-kit that PsiAN and Austen Riggs have created, with information for therapists and tools such as templates for appeal letters and medical necessity evaluations.
Strategies for responding to insurance company audits, denials, requests for records, and reviews.
"Ghost Panels” and their impact on access to care and therapist reimbursement rates
Why the appeals process matters–for patients, therapists, and quality care.
Status update on Wit v UBH, treatment guidelines for depth therapy, and discussion of impact and consequences.
Opportunities for individual and collective advocacy.
Linda Michaels, PsyD, MBA, is a psychologist in private practice in Chicago. She is Chair and Co-Founder of the Psychotherapy Action Network (PsiAN), a non-profit that advocates for quality therapy. She is also Consulting Editor of Psychoanalytic Inquiry, Clinical Associate Faculty at the Chicago Center for Psychoanalysis, and a fellow of the Lauder Institute Global MBA program. She has published, presented and been interviewed by the New York Times, NPR and other national media on the value of psychotherapy, the therapeutic relationship and technology, and the public narrative about therapy. Linda has a former career in business, with over 15 years’ experience consulting to organizations in the US and Latin America.
D. Brian Hufford, JD, was described as “one of the leading ERISA litigators in the country and one of the sharpest legal minds in this area of law” by Chambers USA. He leads an innovative and nationally recognized practice representing patients and health care providers in high stakes disputes with health insurance companies. His efforts led to two of the largest recoveries ever obtained in ERISA-based health insurance class actions, and to a substantial collection of other precedent setting decisions that have transformed the rights of patients and providers, including with regard to behavioral health care and the Federal Parity Act. Brian’s work on reimbursement rate-related litigation against UnitedHealthcare and Health Net, for example, led to settlements worth over $600 million. Brian has served as co-lead counsel in other national health care litigation against UnitedHealthcare, Aetna, WellPoint, CIGNA, and various Blue Cross Blue Shield entities. Brian has successfully argued health care appeals before the U.S. Courts of Appeal for the Second, Third, Fourth, and Fifth Circuits, and was lead counsel in two trials against Blue Cross Blue Shield entities on behalf of providers and provider associations. Brian is one of only three attorneys recognized by Chambers USA in the ERISA Litigation: Mainly Plaintiffs category and is a Law360 "MVP" for Health Care (2015, 2016, and 2017) and Benefits (2019 and 2021). He was chosen as a Plaintiff’s Attorney “Trailblazer” in 2017 and 2021 by The National Law Journal, and has been recognized in industry rankings such as Benchmark Litigation and Super Lawyers. Under his leadership, the firm’s health care practice was named 2017 Health Group of the Year and Benefits Group of the Year in 2018 and 2019 by Law360. Brian was the recipient of the 2021 Rona and Ken Purdy Award to End Discrimination from the National Alliance on Mental Illness. He is a member of the Federal Bar Foundation and the Kennedy Forum Legal Workgroup and has published health law-related opinion pieces in The Washington Post, CNBC.com and many others.
Meiram Bendat, JD, PhD, served as co-counsel for the plaintiffs in Wit v. UBH. He played a critical role in uncovering the UBH guideline flaws and assembling the cutting-edge litigation team that led to plaintiffs’ victory at trial. Dr. Bendat is an attorney licensed by the State Bar of California as well as a psychotherapist licensed by the California Board of Behavioral Sciences. He is the founder of Psych-Appeal, the first private law firm in the United States exclusively dedicated to mental health insurance advocacy on behalf of patients and providers.
David Lloyd, MBA, is the chief policy officer at The Kennedy Forum. Mr. Lloyd is an expert on a range of behavioral health policy issues, including insurance coverage and the Mental Health Parity and Addiction Equity Act of 2008. He has led successful state and federal policy initiatives, including enactment of nation-leading insurance legislation in California, that have increased access to mental health and addiction care for millions of Americans. Mr. Lloyd also has expertise on budget and tax issues and previously served as a legislative assistant to U.S. Senator Debbie Stabenow. He has a bachelor's in History from Cornell University and an MBA from the Kellogg School of Management at Northwestern University.
Kathryn Gallagher, PhD, is a staff psychologist at the Austen Riggs Center. She earned her PhD in clinical psychology from Georgia State University and is a graduate of the Austen Riggs Center Adult Psychoanalytic Training Program and Fellowship in Hospital-Based Psychotherapy. Her graduate research primarily focused on understanding and preventing violence against women, a public health crisis rooted in gender inequality and issues of basic human rights. As a full-time practicing clinician, Dr. Gallagher has shifted her attention to another significant human rights and equity issue–inadequate access to affordable mental health care. Dr. Gallagher is especially committed to supporting efforts to appeal insurer denials of medically necessary mental health treatment.
Along with the panel discussion, PsiAN has created this toolkit to educate and assist therapists and patients in protecting provision of and insurance payment for mental health services. This guide helps therapists address insurance denials, violations of parity, and other treatment limitations that impact providing optimal care for our patients.