The Bills, H.R. 2874 and S. 1576, which are being reintroduced to congress, includes a requirement for insurance providers to disclose the analysis and criteria used to make decisions about covering or denying treatment. Back in 2008 The Mental Health Parity and Addiction Equality Act was originally intended to established parity between the coverage of behavioral health and medical/surgical benefits. While the law made significant strides forward for behavioral health coverage, the lack of parity of coverage still exists. The National Alliance on Mental Illness found in a survey that the rate of denials for mental health care was nearly twice the rate of denials for general medical care. Coincidentally, the bill’s reintroduction comes on the heels of a federal judge’s ruling that found that the nation’s largest insurer, United Health, unlawfully denied beneficiaries access to mental health and substance use disorders treatment in an effort to cut costs.
The Behavioral Health Coverage Transparency Act (H.R. 2874/S. 1576) would require insurance providers to disclose the analysis they utilize in making parity determinations as well as the rates and reasons for mental health/SUD (Substance Use Disorders) claims denials versus medical/surgical denials. It also would require the Department of Health and Human Services, the Department of Labor and the Department of Treasury to undertake a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws. The results of these audits would be made public. Finally, it would establish a Consumer Parity Unit, giving individuals a centralized online clearinghouse to get information about their rights and to submit complaints with assurance of timely responses.
In a statement from Senator Elizabeth Warren, who reintroduced the bill, she notes “Patients with behavioral health concerns deserve the same access to care as patients with physical health conditions, but for far too long, insurance companies have unfairly denied behavioral health care services to cut costs. Our bill would put a stop to these discriminatory practices and make sure patients get the treatment they need.”
I believe that this type of legislation is much needed and long overdue. Over the course of my career in mental health, I have enjoyed watching the evolution of the popular opinion surrounding mental health and the growing acceptance of mental health as a legitimate concern. There is absolutely no reason why mental health treatment shouldn’t get the same kind of coverage that physical health treatment does. It will be interesting to see how this bill does as it works its way through our chaotic system. It will be a huge victory for everyone if it is passed and it is able to be carried out as it is intended.
What are your thoughts the possibility of parity? Would you be more likely to seek mental health services if it was covered in the same way that flu shots are? Let’s hear it OOTers!