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Insurers continue to dodge mental health parity law

KHN analysis finds payers limit treatment through strategies that are difficult to track

Many health insurers continue to dodge covering certain mental health-related costs even after Congress passed the parity law seven years ago, which bans discrimination against treating mentally ill individuals.

An analysis finds that most insurers have dropped annual limits on therapy visits that they will cover, reports Kaiser Health News. And while higher copays and mental health deductibles are less of a problem, insurers limit treatment through other strategies that are more difficult to track.

One such workaround is a "medical necessity" review, a process in which insurers determine whether a patient requires a certain treatment.

Amid consumer complaints and recent lawsuits, only a handful of states have investigated whether insurers follow the rules, notes KHN. What's more, the law was a way for insurers nationwide to provide the same access to treatment as they do other chronic conditions.

Last year, the Department of Health and Human Services found 196 possible insurer violations of the parity law from September 2013 through September 2014, according to KHN, while about 25 percent of plans sold on health insurance exchanges violate the law. But plans either said they complied with the law or voluntarily made changes.

A possible reason for the lack of enforcement stems from health insurers' role in crafting the Affordable Care Act.

"Insurance companies were part of the coalition that helped bring the ACA to life, and the administration feels an enormous debt of gratitude," former congressman Patrick Kennedy, (R.I.-D), one of the authors of the parity law, tells KHN. "It's a challenge politically to then step on the toes of those that brought them to the dance."

However, Clare Krusing, spokeswoman for America's Health Insurance Plans, told the publication that it is a "misperception" that enforcement has been weak, and that insurers "have taken tremendous steps to implement these changes and requirements in a way that is affordable to patients."

For more:
- here's the KHN article

Related Articles:
Study: Exchange plans violate mental parity laws
Mental health access lacking in many states
Let's bring behavioral, mental health into the mainstream