Pre-Payment Review: Do We Have Our First New Mental Health Parity Test Case?
United healthcare's policy of "deciding not pay" is an enforcement opportunity
I’m on a ✈️. It’s the AACAP annual meeting week in Seattle. That is the American Academy of Child and Adolescent Psychiatry. You know, the medical specialists who are very hard to access because many of them are either full, out of network, or both:
While millions of young people suffer from severe mental illnesses, there are only about 6,300 child and adolescent psychiatrists practicing in the United States. There is also a severe maldistribution of child and adolescent psychiatrists, especially in rural and poor, urban areas where access is significantly reduced.1
How dire is the shortage?
The median wait time was 50 days (interquartile range = 29–81 days). In adjusted models, adolescents with Medicaid waited longer than those with private insurance, especially during the spring (geometric mean = 50.9 vs. 41.9 days; p = 0.02).2
Well, don't worry—that is a paper from 2015! It’s only gotten worse since then (this is data from 2023):
Altogether, 948 psychiatrists were sampled in New York…