Mental health services provided by an employer to an employee (or any instance in which a professional business relationship exists) are HMSA benefit exclusions and do not meet payment criteria. Any claims for such services rendered or ordered / prescribed by a provider with business relations to the client will be ineligible for payment under this policy.
This policy aligns with the American Psychological Association’s (APA) Code of Ethics, the American Psychiatric Association Principles of Medical Ethics, and industry standards to ensure transparency, integrity, and compliance with best practices. This commitment helps protect both client and providers from unethical billing practices and ensures that services covered under our health plans meet professional and legal standards.
When significant relationships exist that may conflict with patients’ clinical needs, it is especially important to inform the patient or decision maker about these relationships and potential conflicts with clinical needs. In informing a patient of treatment options, the mental health provider should assist the patient in identifying relevant options that promote an informed treatment decision, including those that are not available from the provider or from the organization with which they are affiliated.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|