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Citing insufficient enforcement of the existing mental health parity law and a lack of transparency, legislators and mental health advocates are seeking solutions to ensure that insurance coverage mirrors that of physical treatment services.
In a hearing before the House Energy and Commerce Committee, behavioral health advocates highlighted several ongoing problems with the Mental Health Parity and Addiction Equity Act passed in 2008, and extended to individual plans through the Affordable Care Act several years later. Rep. Joseph Kennedy (D-Mass.) argued that although provisions of the law aimed to close the gap between mental and physical health coverage, enforcement is still lacking.
“Without proper enforcement and transparency, the law is little more than empty words,” he said.
Previous reports have indicated that access to behavioral health care and substance abuse treatment remains problematic even five years after the parity law was passed, in part because insurers have found ways to deny certain services through medical necessity reviews.
Kennedy, who introduced the Behavioral Health Coverage Transparency Act last year, noted that consumer attempts to understand coverage denials are routinely stymied by insurance carriers, or met with complex and technical documentation. Further, consumers have few options to pursue clarification or file complaints. Matt Selig, executive director of Health Law Advocates Inc., echoed those same concerns, testifying that parity documentation is frequently difficult to obtain or understand.
Pamela Greenberg, president and CEO of the Association for Behavioral Health and Wellness, argued that consumers would be better served if insurers provided a simplified summary of a claims-denial analysis. But she also cautioned against rigid regulation, noting that there are distinct differences between mental and physical treatments.
Earlier this year, President Barack Obama announced the creation of a new task force that would focus on enforcing the mental health parity law. The federal government also finalized a new rule that requires Medicaid and Children’s Health Insurance Program plans to adhere to the same parity regulations as private insurers, and in June, the House passed a new bill that would expand the Meaningful Use program to mental health providers.