Georgia will impose fines of over $20 million on health insurers found to have violated mental health parity laws.
Initial examinations found that insurers have ignored rules and denied Georgians the essential behavioral health resources they deserve, said Georgia Insurance Commissioner John F. King (pictured above).
“We are taking decisive action to hold those who think they can skirt the law accountable. I will not tolerate games, excuses, or stalling tactics from these companies, and we will come after those who try with every tool at our disposal,” King said.
Georgia’s Mental Health Parity Act mandates that insurers cover mental health and substance use disorders at levels equal to physical health services. Georgia’s Mental Health Parity Act was enacted on April 4, 2022 and took July 1, 2022.
By law, the insurance commissioner’s office must collect data from insurers each year by May 15 and issue a compliance report by Aug. 15 to ensure mental health coverage is provided on par with physical health care.
The insurance commissioner's office published its first mental health parity data call report on Aug. 15, 2023.
The latest report flagged concerns, prompting regulators to conduct market conduct examinations of 22 insurers, which uncovered more than 6,000 violations.
By contrast, in 2023, 28 health carriers that responded to the data call demonstrated compliance with the standards, BestWire reported.
The violations found in the recent report typically involved misapplied benefit classifications, unwarranted prior authorization requirements, misuse of concurrent reviews, and unclear claim reprocessing tied to medical necessity.
Each violation carries fines of up to $2,000, or up to $5,000 if knowingly committed. Insurers that fail to comply may also face compliance orders or be required to reprocess affected claims.
The Insurance Commissioner’s office said it will continue monitoring compliance with mental health parity laws through corrective action and enforcement tools available under Georgia law.
It urged consumers who believe they are victims of a violation to file a complaint online or call 1-800-656-2298
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