Quartz insurance fined $500K in Illinois for mental health, addiction violations

The Illinois Department of Insurance (IDOI) issued a $500,000 fine for Wisconsin-based Quartz Health Insurance Corp., which is partly owned by UW Health and UnityPoint Health, for violating the Mental Health Parity and Addiction Equity Act (MHPAEA) as revealed in a comprehensive market conduct examination of the company.

MHPAEA is the federal law requiring health insurance plans to have equivalent levels of coverage for mental health and substance use disorder care as for medical or surgical care, and Illinois law further expands upon those requirements.

Quartz, which offers coverage in northern Illinois, was deemed to have several violations, including requiring prior authorization on substance use disorder claims and leaving brand-name drugs for addiction treatment off its approved list.

Illinois regulators claimed Quartz created barriers to access for certain anti-anxiety and antipsychotic medications, as well as a medication used to reduce cravings for addicts. Additionally, Quartz didn’t let patients with asthma and related ailments fill prescriptions for inhalants a few days in advance, and also made some patients on successful prescriptions undergo “step therapy,” or trying cheaper medications before getting approval for more expensive ones.

Quartz has already paid the fine and agreed to corrective action, and Illinois insurance regulators said they would conduct follow-up exams to ensure compliance.