Court Directs Insurer to Take Fresh Look at Coverage Denial
Denials of health insurance coverage for treatment of behavioral health conditions have been drawing increasing judicial attention. […]
ERISA Ruling Shows Why Insurers Must Justify Claim Denials
Employee benefit claimants’ entitlement to a full and fair review of claim denials prior to judicial intervention is embedded in the Employee Retirement Income Security Act.[1] Regulations promulgated by the
U.S. Department of Labor flesh out the specifics as to what constitutes such a review. […]
Mark DeBofsky Files Amicus Brief in Support of Rehearing En Banc for Landmark Behavioral Health Coverage Case
DeBofsky Law Founder, Mark DeBofsky, filed an amicus brief on March 17, 2023, on behalf of 9 prominent organizations in support of a rehearing en banc in the case of David and Natasha Wit v. United Behavioral Health. […]
How Is Mental Health Parity Enforced?
Accessing mental health treatment can be difficult, even with health insurance. Critical laws are in place to expand access to mental health treatment by requiring equal coverage of mental health and medical/surgical care. […]
Marie E. Casciari to Speak at the Insurance Claims: Empowering Your Clients for Coverage Webinar
Marie E. Casciari will be presenting with a line-up of mental health parity and insurance benefits experts at the “Insurance Claims: Empowering Your Clients for Coverage” Webinar. […]
Medical Necessity Letters to Counter Denial of Mental Health Treatment Claims
A common reason given for denials of health insurance coverage is a “lack of medical necessity.” When an insurance company denies a claim on that basis, that means the insurer disagrees with the patient’s doctor. Medical necessity denials are especially prevalent in claims involving mental health treatment, […]