Action Taken to Ensure Health Insurers Provide Coverage for Maternal Depression Screenings

 

The Department of Financial Services has issued guidance to inform health insurers of their responsibility to provide health insurance coverage for maternal depression screenings. The guidance follows the United States Preventive Services Taskforce recommendations made earlier this year that group health plans and insurers offering group or individual health coverage must provide, with no co-payment, coinsurance or deductible, preventative services such as depression screenings in pregnant and postpartum women.

“We took this action to make sure that all pregnant and postpartum women can receive the full treatment services to which they are entitled,” said Governor Cuomo. “Health insurers have an obligation to cover charges for essential preventative services, and our administration will not hesitate to hold them accountable to that responsibility. This will help mothers and newborn New Yorkers across the state lead safe, healthy lives.”

Acting Department of Financial Services Superintendent Maria T. Vullo said, “DFS is ensuring that mothers struggling with maternal depression receive the screening and treatment they need. Clinical findings have repeatedly shown there is a distinct connection between maternal depression and an increased level of emotional and functional problems in infants, prepubescent, adolescent and adult children. DFS supports families in securing the health insurance coverage they deserve.”

Depression screening for all pregnant and postpartum women is now specifically recommended. Previously, the recommendation for depression screening was limited to non-pregnant adults and only in instances where depression care supports were in place. If care supports were not in place, screening was recommended based upon professional judgment.

DFS strongly urges issuers to start providing coverage for the expanded maternal depression screening as soon as possible and no later than within six months. Additionally, when providing coverage for maternal depression screening, insurers must provide direct access for maternal depression screening and referral for maternal depression from an OB/GYN or pediatrician of the insured’s choice.

In the event a woman seeks mental health services for the diagnosis or treatment of maternal depression, insurers are further reminded that they must comply with all federal and state requirements for coverage of mental health services.

American Psychiatric Association President Renee Binder, M.D. said, “Women with maternal depression need and deserve screening, diagnosis and care. We applaud DFS for its action to help pregnant women and new mothers receive treatment for this all-too-common condition.”

National Institute for Reproductive Health President Andrea Miller, said, “Pregnant women and new mothers deserve high-quality, full-spectrum health care across the board. We applaud Governor Cuomo and DFS for underscoring to insurers that it is incumbent upon them to ensure that pregnant and post-partum New Yorkers get coverage for the preventive mental health care they need.”

Raising Women’s Voices-NY Director Lois Uttley said, “Raising Women’s Voices-NY thanks DFS for alerting health insurers that they must begin covering depression screening for pregnant and post-partum women, without cost-sharing. New York families will benefit tremendously from early detection of pregnancy-related depression and initiation of treatment that can prevent the sometimes-tragic consequences of such depression. The new coverage requirement is great news for pregnant women and new mothers across New York State.”

Nitzia Logothetis, Founder and Executive Chairwoman of the Seleni Institute, said, “This guidance will support a program that is critical to thousands of New York’s women and families. We know that when we support mothers, we support the entire family. We are grateful for Governor Cuomo's ongoing commitment to both the physical and mental well-being of new parents.”

A copy of the NYDFS letter sent to insurers can be viewed here. 

Source: Press Office, Governor Andrew M. Cuomo