Insurance Accountability & Governance

Insurance companies wield unchecked power over behavioral health, shaping not just reimbursement rates but the entire structure of care delivery. They have positioned themselves between clinicians and patients, systematically replacing clinical judgment with profit-driven protocols.

Under the guise of “medical necessity,” insurers restrict session frequency, treatment duration, and covered services, often relying on opaque algorithms to override provider recommendations. But the damage extends beyond utilization review.

Insurers suppress reimbursement for mental health care, delay payments, and routinely issue retroactive denials or clawbacks. They maintain ghost networks to feign access, while independent providers endure excessive credentialing delays designed to favor corporate groups. Mental health professionals face discriminatory treatment, including lower pay, stricter documentation standards, and higher audit risk compared to medical peers.

Contracts often include coercive terms, take-it-or-leave-it rates, gag clauses, and the threat of termination for dissent. These practices are strategic, not accidental, a calculated system of obstruction and exploitation enabled by decades of regulatory failure and political inaction.

The result is a system built to serve shareholders, where care is delayed or denied, patients fall through the cracks, and providers are penalized for putting ethics before profit.