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Settlement means New York insurer must bring mental health coverage in line with primary care

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NEW YORK — New York State Attorney General Eric Schneiderman says he has reached a settlement with insurer EmblemHealth Inc. that will force the company to boost its coverage of mental health services.

Schneiderman said Wednesday that an investigation by his office found that EmblemHealth's subcontractor issued 64 percent more denials of coverage for behavioral and substance-abuse issues than in medical cases.

New York's 2006 mental health parity law says insurers must provide mental health coverage equal to coverage provided for other conditions.

EmblemHealth will be fined $1.2 million under the settlement.

Schneiderman says the company may also have to pay up to $31 million in restitution for claims that were denied.

New York City-based EmblemHealth has 3.4 million members.

An EmblemHealth spokeswoman says new mental health policies have been put in place.

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