Attorney General James Expands Access to Mental Health and Substance Use Disorder Treatment for Millions of New Yorkers
New York Attorney General Letitia James today announced two settlements with Carelon Behavioral Health, Inc. (Carelon) after two Office of the Attorney General (OAG) investigations found that Carelon misled New Yorkers searching for mental health care by directing them to providers who were unavailable and improperly denied coverage for substance use disorder treatment. Carelon administers all behavioral health benefits for several popular health plans, including EmblemHealth, Anthem Blue Cross Blue Shield, Independent Health, and the Empire Plan, the health plan for state and local government employees. Under the settlements, Carelon will pay $2.35 million in penalties, fees, and costs, provide up to $8 million in restitution to eligible members who paid out of pocket for out-of-network mental health care, repay other eligible members for out-of-pocket payments for bills denied by Carelon, and overhaul its provider directories and substance use disorder coverage reviews.
