WASHINGTON—Denial letters from the insurance company kept coming, causing more anxiety for a desperate family.
Linda and David Downey had sent 19-year-old Emaleigh from their home in Beverly to a renowned -- and highly expensive -- residential eating disorder clinic in Tucson, Ariz. In March, their daughter was in serious danger -- her bones protruding, her kidneys and liver failing, her heart rate in the 30s, according to her mother and a Globe review of medical records.
By August, the insurance company, after paying tens of thousands of dollars, decided five months of coverage for the residential treatment was enough. Emaleigh was deemed free of acute symptoms, back to normal weight, and able to follow a treatment plan outside a residential setting.
But for the Downeys, getting that explanation became a problem in its own right. The family said it had to file multiple appeals before getting those details -- a difficulty that advocates and some doctors say is all too common in cases involving mental health coverage.
US Representative Joe Kennedy III, is introducing a bill this week that would require insurance companies to disclose to federal regulators how often they deny mental health or substance abuse claims and cite specific reasons in their analyses for the denials.
To read full Boston Globe article: