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Tags Posts tagged with "Mental Health Parity and Addiction Equity Act"

Mental Health Parity and Addiction Equity Act

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Governor Wolf has announced that several state agencies have been chosen to participate in the federal government’s Commercial Parity Policy Academy, designed to help states better protect consumers through enforcement of federal laws requiring parity between insurance coverage of mental health and substance use disorders and physical health coverage. “The Mental Health Parity and Addiction Equity Act, which has been adopted into Pennsylvania state law, and the Affordable Care Act, both require that mental health and substance use disorder treatments be provided by insurers at parity with physical health coverage, and this requirement is vital for many thousands of Pennsylvanians who need this coverage,” Insurance Commissioner Teresa Miller said. The Parity Policy Academy, conducted by the federal Department of Health and Human Services, will provide state officials with assistance in better enforcing these laws to protect consumers. In addition to the Insurance Department, other state agencies taking part in the Parity Policy Academy include the Department of Drug and Alcohol Programs, the Department of Health, and the Department of Human Services.

Commissioner Miller said her department will be using a $529,000 federal grant under the Health Insurance Enforcement and Consumer Protections Grant Program to enhance parity implementation and enforcement. The Wolf Administration, with the support of the Pennsylvania General Assembly, will continue to coordinate efforts to implement and enforce the laws requiring parity for mental health and substance use disorders. “Substance use disorder services are now being provided for 175,000 Pennsylvanians at parity with physical health services because of the coverage they receive under the Affordable Care Act, and I urge the Trump Administration and Congress to consider these people and how important this coverage is to them, as they debate any changes to this law.”

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A recent edition of the Pittsburgh Post-Gazette focused on the planning efforts by Highmark Insurance to assure health care parity and the economic and health care value of integrated health care.

The Post-Gazette article notes that “behavioral health care is still provided under a “separate and unequal” system, eight years after enactment of a federal law that meant to curb such disparity,” noted Patrick Kennedy in a meeting with a group of Pittsburgh-area health insurance caseworkers. “But that may start to change by fall when employer compliance monitoring is expected to begin for the Mental Health Parity and Addiction Equity Act,” the 49-year-old former Rhode Island congressman told about 20 case managers at Highmark Health. Mr. Kennedy was upbeat, saying a renaissance was at hand as employers and insurers learn about the cost-saving value of behavioral health coverage. “The business model isn’t there yet. This is going to take time,” he said. “Let’s find the value so it makes sense for insurance companies.”

In a related effort, the Pennsylvania Parity Coalition will be meeting this week with the Pennsylvania Insurance Department, to discuss the implementation and monitoring of commercial insurance plans as part of the federal parity requirements in the move toward integrated health care. RCPA, along with leading provider and consumer advocacy groups and representatives of ParityTrack, supported by the Kennedy Forum, make up the core leadership of the Pennsylvania Parity Coalition.

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Last week Insurance Commissioner Teresa Miller reiterated to consumers that enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) is a priority for her department. Miller also encouraged consumers to understand what benefits they are entitled to under the law and to file complaints with the Insurance Department if they believe they are not getting proper insurance coverage. “The Pennsylvania Insurance Department takes this law very seriously, and we will us our statutory authority to enforce parity requirements on plans over which we have jurisdiction,” said Commissioner Miller.

The MHPAEA of 2008 requires health insurance plans to contain the same level of coverage for mental health and substance use disorders as for medical or surgical care. This coverage includes quantitative limitations (copays, deductibles, and limits on inpatient or outpatient visits that are covered) and non-quantitative limitations (pre-authorizations, providers available through a plan’s network, and what a plan deems “medically necessary”).

One important step toward a well-integrated system of health care, both physical and behavioral, is full implementation of the letter and spirit of MHPAEA. RCPA is actively working with health care advocates as part of the state’s Parity Coalition to assure consumers and providers/practitioners that Medicaid, CHIP, and private health plan coverage include quantitative and non-quantitative parity.

For more information on the MHPAEA or to file a complaint or ask a question, visit the insurance department website or call 877-881-6388.

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