Quartz insurance fined $500,000 in Illinois for mental health, addiction violations

A market exam from 2021 to 2022 of Quartz, which offers coverage in northern Illinois, found several violations, including requiring prior authorization on substance use disorder claims and leaving brand-name drugs for addiction treatment off its approved list.

Regulators said Quartz had barriers in consumer access to Naltrexone, a craving reduction medicine for alcohol and opioid use disorder, and limited anti-anxiety and antipsychotic medications to a maximum fill of 30 days, even though the typical allotment is 90 days.

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In addition, Quartz didn't let patients with asthma and related ailments fill prescriptions for inhalants a few days in advance, deeming that too soon. It also made some patients on successful prescriptions undergo "step therapy," or trying cheaper medications before getting approval for more expensive ones.

"Creating barriers to mental health and substance use disorder treatment places an additional burden on our fellow Illinoisans who are already struggling," Dana Popish Severinghaus, director of the Illinois insurance department, said in a statement. "We will not allow companies to jeopardize access to treatment for those in need."

Quartz has paid the fine and agreed to corrective action, and Illinois insurance regulators said they would conduct follow-up exams to ensure compliance.

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Myranda Tanck, director of external affairs at Quartz, said the company worked with the Illinois insurance agency throughout the process.

"We will continue to work with the department to ensure compliance with state statute and above all, to ensure Quartz is best serving our members in the state," Tanck said in a statement.

Sarah Smith, spokesperson for the Wisconsin Office of the Commissioner of Insurance, said the agency has not taken action against Quartz but is reviewing the action taken in Illinois.

Quartz is owned by Advocate Aurora Health, Gundersen Health System, UW Health and UnityPoint Health, which owns Meriter Hospital in Madison.