Today’s front page of The New York Times reports that long-awaited regulations will complete a generation-long effort to require insurers to cover care for mental health and addiction, just like physical illnesses.
This process began back in 2008 when the government passed the Mental Health Parity and Addiction Equity Act. However, the laws associated with this Act have not been well enforced until now. Today’s new regulations will put into effect the 2008 Act and affect approximately 85 percent of the American population.
The regulations will ensure that health plans’ co-payments, deductibles and limits on visits to health care providers are not more restrictive or less generous for mental health benefits than for medical and surgical benefits. Significantly, the regulations would clarify how parity applies to residential treatments and outpatient services, where much of the care for people with addictions or mental illnesses occurs, The Times reports. Any geographic or facility-type limitations would have to be comparable for medical and mental health benefits.
Next year will be a turning point because "mental health has become too big to ignore," Paul Summergrad, M.D., President-Elect of the American Psychiatric Association and Chair of the Department of Psychiatry at Tufts University School of Medicine told The Times. "These are problems that are just too common."
A person who has a heart attack or pneumonia and goes to a hospital will routinely be admitted, with electronic notice sent to the insurer on the next business day, Dr. Summergrad said. By contrast, he said, if a person who is profoundly depressed and tried to commit suicide goes to a hospital, an emergency room doctor must call a toll-free telephone number, “present the case in voluminous detail and get prior authorization.”
Read more in the New York Times Article.