Articles Tagged with mental health

On Monday, the White House issued President Trump’s Executive Order on Saving Lives Through Increased Support For Mental-and Behavioral-Health Needs, which orders the creation of a Coronavirus Mental Health Working Group (“the Working Group”), the submission of a plan by the working group for addressing mental health impacts of COVID-19, and calls for agencies to maximize support, including safe in-person services, for Americans in need of behavioral health treatment. The Working Group will issue recommendations in 45 days.

Health and Human Services Secretary Alex Azar, who will serve as co-chair for the Working Group, issued the following statement,

“We know that the COVID-19 pandemic has created or exacerbated serious behavioral health challenges for many Americans, both adding new stresses and disrupting access to treatment. The President’s Executive Order is a welcome opportunity to increase efforts to address the mental health effects of the pandemic, which have already included hundreds of millions of dollars in grants and historic flexibilities to ensure Americans can continue to receive treatment for mental illness and substance use disorders.”

On Friday September 25, 2020, California Governor Gavin Newsom signed a law that strengthens and expands mental health parity protections in California. This law amends the California Mental Health Parity Act by adding significant new protections that are good news for participants in both group and individual healthcare insurance policies (including disability policies that cover healthcare), and bad news for insurance companies that have continued to unfairly deny medically necessary coverage for the treatment of mental health and substance use disorders. Co-Founding Partner Lisa S. Kantor, working with other mental health advocates and one of the bill’s sponsors, was instrumental in the development of this law.

Among other highlights, the new law now covers all generally recognized mental health disorders as well as substance use disorders, whereas the prior law only covered a list of nine mental health disorders that were deemed severe. The legislature found the prior list was “not only incomplete and out-of-date, but also fails to encompass the range of mental health and substance use disorders whose complex interactions are contributing to overdose deaths from opioids and methamphetamines, the increase in suicides, and other so-called deaths of despair.”

The law clarifies that insurers must cover treatment at all intermediate levels of care for mental health and substance use disorders, including residential care, partial hospitalization, and intensive outpatient treatment. The legislation expressly cites two groundbreaking decisions in cases brought by Kantor & Kantor’s Co-Founding Partner  Lisa KantorHarlick v. Blue Shield of California, and Rea v. Blue Shield of California – in which courts in California required residential treatment be covered under the prior law. Nevertheless, insurers have continued to insist that the California Mental Health Parity Act does not mandate necessary residential treatment for mental health disorder patients, an argument that should no longer be viable.

September 6 – 12, 2020 is the American Foundation for Suicide Prevention’s (AFSP) annual National Suicide Prevention Week. This year’s message is: #KeepGoing. AFSP reminds us all that there are simple things we can each do in order to protect and safeguard our mental health, and that together, we can make a difference on the mental health of our community and those around us. . . and…together we can #KeepGoing!

As someone who overcame years of contemplating suicide as an option, and as who has lost too many people to suicide to name herein, suicide prevention is personal to me –as I am sure it is to many of you reading this. So, please do what feels right to you this National Suicide Prevention Week –get involved in ways that nourish your Self and soul. ~ And, please, most importantly: if you are struggling with ideas of taking your life or completing suicide…please do not follow-through. I know how it feels like the only option. But I am here to tell you that I will never regret not following through on the thoughts. There is hope for you – hope for your brighter days ahead and for a life free from thinking that the world would be better off without you. Indeed, you are very necessary. Get help today if you need help -you deserve it.

During this week of advocacy, education, story sharing, remembrance and more, AFSP encourages us to:

National Post Traumatic Stress Disorder (“PTSD”) Awareness Month is commemorated annually in June. The month is dedicated to raising awareness of PTSD and how to access treatment. June 27 is also recognized annually as PTSD Awareness Day.

According to the National Center for PTSD, between 7 and 8 percent of the population will experience Post Traumatic Stress Disorder (PTSD) during their lifetime. Men, women, and children can experience PTSD as a result of trauma in their lives. Events due to combat, accidents, disasters, and abuse are just a few of the causes of PSTD. No matter the reason, PTSD is treatable, but not everyone seeks treatment, or some people seek treatment and they are denied benefits by their health insurer.

Common symptoms of PTSD might include:

Kantor & Kantor has established a regular, live, and interactive Zoom conversation to discuss generally and answer questions from the public about long-term disability, health insurance, pensions, life insurance, casualty (homeowners), and more.  BenefitsChat will be live on Wednesday evenings from 5:00 pm – 6:30 pm Pacific Time.

Host Andrew Kantor, his fellow Kantor & Kantor attorneys, and select guests will explain and discuss everything from “big picture” concepts, such as the distinctions between different ways of obtaining insurance, to case-specific concepts designed to help individuals protect their rights.

While there is always a demand for legal information, current events have created an unparalleled need for as many real, live, helping hands as are available to be lent—even if the hand can only be safely lent via webcam. This forum will give people the chance not only to learn from our attorneys and each other; but to do so within the safety and comfort of a like-minded and supportive group of individuals and their families.

Two decisions this week emphasize the importance of submitting treating physician and patient statements in support of an ERISA administrative appeal. For ERISA health cases involving medical necessity denials, an appeal which gets to the heart of why treatment was medically necessary is crucial and can actually determine the course of the lawsuit.

In Katherine P. v. Humana Health Plan, Inc., No. 19-50276, __F.3d__, 2020 WL 2479687 (5th Cir. May 14, 2020), the Fifth Circuit revived life into a claim by a young woman seeking mental health benefits for partial hospitalization treatment. Katherine received partial hospitalization treatment in 2012 for multiple mental health disorders including an eating disorder. Humana paid for the first 12 days of partial hospitalization treatment and then denied benefits, claiming such treatment was no longer medically necessary based on two Mihalik Criteria.

The Fifth Circuit found that judgment for Humana was improper because the administrative record showed a genuine dispute as to whether Katherine satisfied one of the Mihalik Criteria, ED.PM.4.2.

For Immediate Release

May 7, 2020

Kantor & Kantor, LLP and Dawson & Rosenthal, P.C. FILED A COMPLAINT in the United States District Court, Central District of California on behalf of their client Sovereign Health, a Gold Star Award winning healthcare provider that treated mental health, substance abuse, and dual diagnosis patients . The $1.125 billon suit alleges that Health Net, Centene Corporation, attorneys from Manatt, Phelps & Phillips, and others engaged in practices that are in violation of the Racketeer Influenced and Corrupt Organizations Act (RICO); Conspiracy to Violate RICO; Intentional Interference with Prospective Economic Advantage, Violation of Unfair Competition Law; and Slander.

Millions of people are affected by mental illness each year. While 1 in 5 people will experience a mental illness during their lifetime, everyone faces challenges in life that can impact their mental health. As the increase in the number of COVID-19 cases affects our entire country, so too will the need for access to mental health treatment and awareness of mental health issues. So far, older adults, along with those who have underlying health conditions, have been hit the hardest by the COVID-19 outbreak, with many developing severe, life threatening illnesses. Another group that is expected to be acutely affected by the pandemic include those who have severe mental illness.

Mental illness is a real and treatable set of conditions that includes major depression, bipolar disorder, eating disorders, panic attacks, generalized anxiety disorder, attention deficit hyperactivity disorder, and schizophrenia, among dozens of others. These disorders are serious enough to significantly impact a person’s daily life functioning, whether at school, work or in their relationships with others.

Mental health issues often coincide with a unique set of challenges that make it difficult for people to access even the most necessities, such as food, medications, stable housing, and healthcare. Combined, all these factors put people with severe mental illness at a much higher risk for contracting and transmitting the new coronavirus and dealing with COVID-19.

As we might expect during this time of pandemic, state governments are not able to make progress on many pressing issues. In January, California governor Gavin Newsom unveiled a $47 billion proposal to expand health care coverage to all Californians. However, the coronavirus scourge has sidelined that proposal as California has scrambled to find funds to respond to it.

Due to these funding pressures, Governor Newsom has asked lawmakers to prioritize their legislative agendas and focus on the outbreak. One senator, however, is pushing ahead with a proposal to protect Californians suffering from mental illness.

As reported by Kaiser Health News, California State Senator Jim Beall, who is the chair of the Senate Select Committee on Mental Health, wants to toughen state parity laws to ensure that patients with mental illnesses are provided benefits on par with those received by patients with other medical conditions. California and the federal government already have mental health parity laws on the books, but Senator Beall argues that they are not stringent enough and are poorly enforced.

The past few months have heralded an unprecedented situation. Millions of Americans are being laid off as COVID-19 shuts down businesses throughout the nation. This is frightening for everyone.  It is doubly difficult for workers who have physical or mental limitations.  For those workers, the specter of finding a new job in this economy, one that can accommodate their often significant limitations, may be overwhelming.

Workers experiencing health issues — including cognitive issues or mental illnesses — who have been having difficulties performing their jobs because of those limitations but have been fighting through them, may well be among the first to be laid off as underperformers. While these workers are in fact impressive in their drive to keep working in the face of daunting health issues, that very refusal to admit defeat may result in unemployment and a lack of income for them.

If you are among these workers, now is the time to evaluate whether a disability claim makes sense for you. While you still have access to your job-related insurance, you can preserve some of your income and access to health insurance.  If you have ongoing medical issues for which you have already been treating that significantly impact your ability to work, be it physical pain, chronic illness, depression, anxiety, or auto-immune issues, talk to your doctor about whether he or she would recommend disability for you.

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