Al Redmer Jr. has had two stints as the head of the Maryland Insurance Administration, the first from 2003 into 2005, the second from January 2015 until the present. He’s the person many people turn to for help with insurance questions.
“It is not unusual for folks that I know to call me looking for help or direction related to insurance issues,” Redmer said. “Those calls could come from patients, family members or providers.”
In this second stint as insurance commissioner, however, Redmer and the administration noticed two things: More people were calling him with questions regarding addiction treatment, and despite the increasing volume of those calls, few people seemed to know about his agency.
“The takeaway that we learned was that there are a lot of folks out there that don’t know the Maryland Insurance Administration even exists,” Redmer said. “And they don’t know how we can help with health insurance-related issues.”
And so the administration created a plan to change that. At 11 a.m. on Wednesday, March 7, the administration will host the next in a series of free webinars to help people better understand what the administration can do for them, with a special focus on addiction and mental health issues. The number to dial in by phone is 240-454-0887, the meeting number is 733 437 952 and the meeting password is R3K2pBCP. The video can be streamed on their website.
“If somebody is either addicted, or a family member or a close friend of somebody that’s addicted, or a provider providing services to those that potentially are addicted, they should probably tune in,” Redmer said. “We may be able to help in the event that they are having problems accessing care and treatment.”
The Insurance Administration regulates the business of insurance in order to protect consumers, Redmer said.
“We make sure that the contracts are enforced and that the carriers comply with Maryland law,” he said. “If an insurance carrier denies a service or a claim, folks can come to us, they can file a complaint. We will do an investigation and make a determination as to whether the carrier is following the rules or not.”
And the administration has the tools and authority to ensure a carrier course corrects after being found in violation of the rules, according to Redmer.
“We can require them to perform services they don’t want to perform,” he said. “We can make them pay claims they don’t want to pay.”
The Insurance Administration investigates complaints about insurance carriers not providing required coverage, Redmer said, which are usually either general complaints, or complaints associated with emergency services. A general complaint will be investigated over the course of a week or so, but emergency situations are given priority.
“If it is an emergency denial, we are literally available by phone, 24/7, 365 a year, and we turn it around in 24 hours,” Redmer said. “So where someone is potentially suicidal and there is a dispute over whether they need to be admitted or not, those are things we take very seriously and we turn those decisions around very, very quickly.”
The administration can be reached by calling 410-468-2340 or 1-800-492-6116.
In the case of addiction treatment, Redmer said, the most common complaints stem from admittance or discharge from a drug treatment facility.
“If, as an example, John or Jane Doe need drug addiction services and the insurance carrier, for whatever reason, says, ‘We don’t want to do an inpatient treatment,’ or, ‘We don’t want to pay for something,’ they can come to us and we can — under the right circumstances — require them to admit folks they don’t want to admit,” he said. “If the insurance company says, ‘We think John or Jane has been here long enough, we’re going to send you home,’ and the patient, family members or provider disagree with that assessment, they have a place to turn and that’s with us.”
These issues will be covered in more detail during Wednesday’s Webinar, according to Redmer, but for those who cannot make that appointment, a recording will be made available online at insurance.maryland.gov, where he said people can find many other materials relate to insurance regulations. The slides from a recent, similar webinar can also be accessed on the website.
And when it comes to what sorts of issues rise to the level of an issue the Insurance Administration should take a look at, Redmer said he trusts people’s guts.
“You have a pretty good feeling of whether it’s right or wrong,” he said. “I always encourage folks, when in doubt, call us and we’ll tell you whether we think there is a potential issue or not.”