The Illinois Department of Insurance fined Quartz Health Insurance Corp. $500,000 for violating state and federal laws that require equal levels of coverage for mental health and substance abuse care as for medical care.
The state conducted a market conduct exam from 2021 to 2022 that found several violations, according to a Jan. 11 news release.
Quartz's parent company is jointly owned by Downers Grove, Ill., and Milwaukee-based Advocate Aurora Health, La Crosse, Wis.-based Gundersen Health System, West Des Moines, Iowa-based UnityPoint Health, and UW Health in Madison. The company provides coverage to more than 350,000 members in Illinois, Iowa, Minnesota and Wisconsin, according to eHealth.
The report found that Quartz imposed prior authorization on substance abuse claims and for the drug Naltrexone, which reduces cravings for alcohol and opioids. The company also failed to include all FDA-approved substance abuse medications on its formulary and it improperly imposed step therapy when members were already on a successful prescription drug.
The state said Quartz has paid the fine and agreed to take corrective action. Illinois will also conduct follow up compliance exams.