Twenty-two health insurance companies in Georgia have violated state law and will pay a total of $20 million for not covering mental health equally to physical health, Georgia Insurance Commissioner John King announced Friday.
His office found more than 6,000 violations among the insurers in the market, including some that inconsistently applied benefits and required approval from the insurer prior to care even when that approval was not necessary.
King’s office did not immediately provide the names of the 22 companies.
The state said the insurers broke a 2022 law enacted in response to pleas from mental health and addiction recovery advocates in the wake of the opioid crisis and the COVID-19 pandemic. King’s office is in charge of regulating who gets to offer insurance in Georgia.
“The time to get in compliance with the law was yesterday,” King said in a written statement. “Today, we are taking decisive action to hold those who think they can skirt the law accountable. I will not tolerate games, excuses, or stalling tactics from these companies, and we will come after those who try with every tool at our disposal.”
A group that represents nine of the sanctioned insurance companies, the Georgia Association of Health Plans, said the results of the audits may be outdated. The organization said the companies don’t yet have their specific audit results in hand, but they hear the audits cover 2022 data, when the law was new, and not the years since when their mental health spending increased “significantly.”
“Our health plans are committed to ensuring that their members can access vital mental health care services when they need them,” the insurers said in a written statement.
Health insurance is a multibillion-dollar business in Georgia. It is not clear how the $20 million in fines compares to the amount the companies apparently saved by skimping on covering mental health treatment.
“In my opinion, it’s not even close,” said Jeff Breedlove, an advocate for addiction recovery patients. “I hope that big insurance isn’t adopting a policy that it’s easier to pay a fine than provide services to the families of Georgia.”
Representatives for some of the companies fined by the state did not immediately comment when contacted by The Atlanta Journal-Constitution.
Mental health advocates have blasted the companies and King’s office for what they say has been a failure to follow the law and sluggish attention to its provisions. They scheduled a rally at the state Capitol on Monday. Advocates said the rally will still go on as planned.
The sweeping 2022 Mental Health Parity Act requires insurance companies to provide equal coverage for mental and physical health care. That means patients should have the same copays, deductibles and number of sessions for anxiety, depression or addiction as for illnesses of the rest of the body.
But advocates and a bipartisan group of lawmakers have criticized King for failing to enforce the law, or boost awareness of it. It’s not clear how many patients understand their rights, or how to file complaints. The state may have found thousands of violations, but the official complaint process resulted in only 13 unique complaints about mental health violations reported to the state in 2024.
King’s office addressed the criticisms of the state’s process, saying enforcement takes time.
In the news release, King said his office has been studying the 22 insurers who were fined since 2023 and that the analysis can “often take several months or years to conduct based on the size of the company, complexity of the examination, and need for accurate results that stand up under legal scrutiny.”
Experts have said states conducting proactive investigations into insurers can lead to better service for consumers, but fines need to be significant enough for insurers to feel them.
“If the fines are spread across more than 20 noncompliant insurers,” said Roland Behm, a mental health advocate who assisted legislators in drafting the law, “the per insurer fine is underwhelming.”
Behm and Breedlove both said they were grateful for a first step.
“Thank you for working on this important issue for Georgia families. It’s a big deal, but it’s a beginning not the end,” said Breedlove, the strategic policy adviser for the Georgia Council For Recovery.
The amount marks one of the largest fines levied by the Office of Insurance and Safety Fire Commissioner. In 2022, the state fined one company, Blue Cross Blue Shield, also known subsequently as Anthem or Elevance, $5 million for a repeated, yearslong pattern of violations of policyholder’s rights.
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