According to the state, the insurers violated a 2022 law that was passed in response to appeals from activists for addiction treatment and mental health in the wake of the COVID-19 pandemic and the opioid crisis. King’s agency is responsible for overseeing the licensing of insurance providers in Georgia.
King stated in a written statement that yesterday was the deadline for complying with the law. We are acting decisively today to hold accountable those who believe they can evade the law. I will not put up with these firms’ games, excuses, or stalling tactics, and we will use every available weapon to pursue any who attempt.
The Georgia Association of Health Plans, an organization that represents nine of the sanctioned insurance firms, stated that the audits’ findings might not be current. The organization stated that although the corporations have not yet received their individual audit results, they have heard that the audits involve data from 2022, when the law was new, rather than the years after a huge increase in their spending on mental health.
According to a written statement from the insurers, “Our health plans are dedicated to making sure that their members can access essential mental health care services when they need them.”
In Georgia, the health insurance industry is worth billions of dollars. The $20 million in fines and the money the firms reportedly saved by cutting back on mental health treatment coverage are not clearly comparable.
Jeff Breedlove, a supporter of people in addiction treatment, stated, “I don’t think it’s even close.” I hope that large insurance companies aren’t implementing a policy that makes it simpler to pay a fee than to offer assistance to Georgian families.
When contacted by The Atlanta Journal-Constitution, representatives for a few of the businesses that the state had fined did not immediately respond.
Advocates for mental health have criticized King’s office and the firms for allegedly disregarding the law and paying little heed to its provisions. On Monday, they planned to hold a rally at the state Capitol. The rally will continue as scheduled, according to advocates.
Insurance companies are required by the comprehensive 2022 Mental Health Parity Act to offer equal coverage for both physical and mental health care. This implies that people with addiction, depression, or anxiety should pay the same copays, deductibles, and number of sessions as those with other conditions.
However, King has come under fire from activists and a bipartisan group of lawmakers for not upholding the law or raising awareness of it. How many patients are aware of their rights and how to lodge complaints is unclear. Even though the state discovered hundreds of infractions, only 13 distinct complaints regarding mental health violations were submitted to the state in 2024 as a consequence of the formal complaint procedure.
In response to the state’s process criticisms, King’s office stated that enforcement takes time.
King stated in the news release that his office has been researching the 22 insurers that have been fined since 2023. Depending on the size of the company, the intricacy of the investigation, and the requirement for precise findings that withstand legal scrutiny, the analysis can frequently take months or years to complete.
According to experts, states that take proactive steps to investigate insurers can improve consumer service; however, the penalties must be substantial enough for insurers to notice.
Roland Behm, a mental health advocate who helped lawmakers develop the law, said the sanctions per insurer are insufficient if they are distributed among more than 20 noncompliant insurers.
Both Breedlove and Behm expressed gratitude for a starting step.
We appreciate your efforts on this crucial matter for Georgian families. “It’s a big deal, but it’s just the beginning,” stated Breedlove, the Georgia Council for Recovery’s strategic policy adviser.
The sum is among the highest fines the Office of Insurance and Safety Fire Commissioner has ever imposed. One business, Blue Cross Blue Shield, which later changed its name to Anthem or Elevance, was fined $5 million by the state in 2022 for repeatedly violating policyholder rights over a period of years.
