The Weston Forum - Rule change increases mental health parity
News Article
By The Forum Staff
The Department of Health and Human Services has finalized a rule increasing parity between mental health disorder benefits and medical/surgical benefits in group and individual health plans. This will help ensure that co-pays, deductibles, and visit limits are not more restrictive for mental health and substance abuse disorder benefits than they are for medical and surgical benefits.
"I am extremely pleased that this rule is being put into effect to bring mental health service benefits in line with the health benefits already enjoyed by millions of Americans," said U.S. Rep. Jim Himes, a Democrat who represents the 4th District, which includes Weston. "This important rule will help end the stigma associated with mental illness and help those suffering from mental illness get the help they need so that tragedies like Sandy Hook never happen again."
Gov. Dannel Malloy agreed. "This rule is a major, long overdue step towards expanding access to treatment for people in our country living with mental health conditions. I thank the Administration for acting. For too long, mental health issues have been unfairly stigmatized in our society to the point that has resulted in many Americans not having access to the critical treatment that could change their lives. We have seen too many examples of unfortunate events that could have been prevented if only this sort of medical treatment was accessible and utilized."
The rule is one of 23 executive actions outlined by President Obama in January to reduce gun violence in the wake of the Sandy Hook shooting.
In addition to ensuring parity for mental health services, the new rule will also:
Ensure that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings;
Clarify the scope of the transparency required by health plans, including the disclosure rights of plan participants;
Clarify that parity applies to all plan standards, including geographic limits, facility-type limits and network adequacy; and
Eliminate a provision that allowed insurance companies to make an exception to the non-quantitative treatment limitation (NQTL) parity requirements for certain benefits based on "clinically appropriate standards of care," which clinical experts advised was not necessary and which provided a potential loophole.
Source