APA Asks Federal, State Officials to Examine Anthem, Cigna Merger
The APA is concerned that the merger will strengthen the insurers' buying power of psychiatric services to patients' detriment.
The American Psychiatric Association has joined other medical associations, including the American Medical Association and the American Academy of Family Physicians, in expressing concern to insurance commissioners and state attorneys general about the negative impact the proposed merger between Anthem and Cigna would have on patients' access to mental health resources.
In the letter, which was also sent to the Department of Justice and the Federal Trade Commission, APA President Renee Binder and CEO and Medical Director Saul Levin, MD, MPA, write that “combined insurance companies with substantial buying power will strengthen their control over the purchase of psychiatric services.
“Moreover, the merging of companies that have a demonstrated history of discrimination against individuals with mental illnesses will only exacerbate access to mental health care services in the United States.”
In Late July, Anthem, which owns many Blue Cross and Blue Shield plans, said it would acquire Cigna for $54 billion in a deal that is expected to close in the second half of next year. Should it go through, it would leave the country with just three major insurers: United Healthcare, Aetna (which has its own merger with Humana) and Anthem.
Among the concerns outlined in the letter is the APA's contention that insurers pay psychiatrists less for the same services provided under CPT codes than other physicians, discouraging them from participating in insurers' networks. The organization noted that it has already filed litigation against Anthem for this practice, claiming it violates the Mental Health Parity and Addiction Equity Act.
The APA also encourages officials to see how Anthem and Cigna have fared in providing access to mental health services by asking for data on claims filed by psychiatrists, gathering data on claims on out-of-network versus in-network mental health providers as opposed to other clinicians, and comparing the denial rates in mental health claims versus other claims.