Here are the new Colorado laws that go into effect Jan. 1<\/a><\/p>\n\u201cPreviously, insurance companies used their own internal determinations for deciding if a mental health service was medically necessary,\u201d said Mary Kate Morr, with Healthier Colorado, a public health advocacy group that pushed for the legislation. \u201cThis law says that really that decision should be between a doctor and their patient, not an insurance company.\u201d<\/p>\n
Morr said the law ensures that Coloradans can access the care they are paying for without facing a crushing financial strain.\u00a0<\/p>\n
\u201cIf you need mental health care, you shouldn\u2019t have to go into crippling debt to get it and you shouldn\u2019t have to be in a full-blown crisis and potentially lose a loved one to suicide,\u201d she said.<\/p>\n
The law also requires insurers to clearly explain any denial and base it on national standards of care, making the appeals process more transparent.\u00a0<\/p>\n
\u201cPreviously, families often didn\u2019t even know why claims were being denied, making appeals confusing and difficult,\u201d Morr said.<\/p>\n
Mona Abaza, an ear, nose and throat doctor and mother, spent years fighting her insurance company to get care for her daughter, who struggled with self-harm. Doctors recommended inpatient care, but her insurer refused coverage.\u00a0<\/p>\n
\u201cIt\u2019s not like I\u2019m sending her to a nice camp so she can get into an Ivy League school,\u201d Abaza said. \u201cI was sending her somewhere because they told me I was saving her life. If she came home, they were concerned that she would kill herself.\u201d<\/p>\n
Despite her medical knowledge and resources, Abaza said navigating mental health coverage was difficult. She took out a second mortgage to pay for her daughter\u2019s care out-of-pocket, and despite fighting legally, she was never reimbursed by her health insurance.\u00a0<\/p>\n
\u201cI felt blessed that I\u2019m in a financial situation where I can take out a second mortgage, where I had family that could help support me\u201d Abaza said. \u201cI felt deep sadness for those parents who couldn\u2019t.\u201d<\/p>\n
Abaza hopes the new law will prevent other families from facing the same struggles.\u00a0<\/p>\n
\u201cI think [this law] will get people the care that they need,” Abaza said. “I truly hope it will begin to allow us to think of mental healthcare as just health care.”\u00a0<\/p>\n
Healthier Colorado said the law also establishes standardized criteria for determining medical necessity and stops insurers from reversing medical necessity decisions except in cases of fraud.<\/p>\n
\u201cNow, if an insurance company denies a claim, the process will be very standardized and transparent,\u201d Morr said. \u201cIt\u2019s better for families, it\u2019s better for patients and ultimately, it\u2019s better for all of us as Coloradans.\u201d<\/p>\n
Abaza believes the law will save lives and reduce the financial burden for families in crisis. Her daughter is now a healthy, happy sophomore in college.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Advocates said the law ensures that Coloradans can access the care they are paying for without facing a…\n","protected":false},"author":2,"featured_media":388136,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[64,63,137,514,515],"class_list":{"0":"post-388135","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-au","9":"tag-australia","10":"tag-health","11":"tag-mental-health","12":"tag-mentalhealth"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/388135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=388135"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/388135\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/388136"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=388135"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=388135"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=388135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}