Mental health parity rules unfair, charge insurers

The interim final rules published in the Feb. 2 Federal Register implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 may provide mental health parity to group health plan members, but certain elements of the rule could "hamstring" insurers' and employers' ability to effectively manage mental health benefits, Pamela Greenberg, president of the Association for Behavioral Health and Wellness, tells the New York Times.

The Blue Cross and Blue Shield Association and other insurers want the federal government to rescind provisions involving the regulation of "nonquantitative treatment limits," including insurer payment rates, as well as a provision requiring that they have one deductible for all medical and mental health services combined. But patient advocates argue the rules are necessary to prevent insurers from attempting to go around the law. Some insurers have tried to do just that by "imposing new requirements for prior authorization and the submission of treatment plans for mental health services where there were no comparable requirements on the medical-surgical side," charges Dr. James Scully Jr., chief executive of the American Psychiatric Association.

UnitedHealth Group in Minnetonka, Minn., has provided comments on the interim rules stating that they go "beyond the intent of the 2008 parity law, and, in doing so, create complexities that will have unintended, negative consequences and will disrupt access to appropriate behavioral healthcare." UnitedHealth warned that not allowing separate deductibles (e.g., $250 each for mental health and other care) will result in higher single deductibles across the board (e.g., $500 combined deductible for all members), reports National Public Radio.

"In this scenario, the impact is not limited just to those plan participants seeking mental health or substance use disorder treatment," United said. "This change will also result in greater out -of-pocket costs to plan participants seeking medical care." Among other changes, UnitedHealth also wants to postpone implementation from July 1, 2010, to July 1, 2011.

To learn more:
- read this New York Times article
- review the interim final rules
- read this National Public Radio blog post
- read the UnitedHealth letter

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