The Georgia Office of the Commissioner of Insurance and Fire Safety (OCI) announced that Commissioner John F. King will issue more than $20 million in fines to health insurers for violations of Mental Health Parity laws.
According to a press release, the Georgia OCI is responsible for ensuring compliance with both state and federal mental health parity laws. These laws mandate that health insurers provide coverage for mental health and substance use disorders on par with physical health conditions. The agency conducts annual data reviews of insurance practices, including benefit applications and treatment limitations, culminating in a report published each August. When potential violations are detected, the OCI undertakes detailed market conduct examinations to evaluate insurer compliance.
The first data call in 2023 resulted in investigations into 22 insurers, revealing more than 6,000 violations during audits. Issues identified included inconsistent classification of benefits, improper use of prior authorization, and unclear application of medical necessity reviews. Under Georgia law, penalties for such violations can reach up to $5,000 per instance, depending on the insurer’s awareness of the issue. Besides financial penalties, insurers may be required to implement or adhere to compliance plans, reprocess claims, or take corrective action. The OCI will continue monitoring enforcement to ensure adherence to parity requirements.
“The time to get in compliance with the law was yesterday,” said King in a press release by OCI. “Today, we are taking decisive action to hold those who think they can skirt the law accountable. I will not tolerate games, excuses, or stalling tactics from these companies, and we will come after those who try with every tool at our disposal.”
The OCI is tasked with regulating insurance and building safety in Georgia. Its mission is to protect families and ensure access to essential insurance products through fair oversight that supports economic opportunity. John F. King has served as Commissioner since 2019 and became the first Hispanic statewide official in Georgia upon his election to a full term in 2022. His background includes decades in law enforcement as Doraville’s Chief of Police and a distinguished military career as a U.S. Army Major General. King holds advanced degrees in criminal justice and strategic studies and has completed national and international security training programs.
