September 14, 2011

Insurers Still Skirting Mental Health Parity Law

Hopefully this problem will come to an end. It is disturbing that our medical insurance industry continues to sidestep the law and continues to discriminate against patients with mental illnesses. Some companies will cover some conditions with no problems, but for the majority of mental health illnesses, they will drop the coverage as soon as they can and many drop all coverage after a patient is diagnosed with a mental illness.

I am not saying this is the case, but it may go a long ways to explain why doctors are prescribing antidepressants without a diagnosis. I had not considered this when I wrote my blog here. The Mental Health Parity and Addiction Equity Act passed into law in 2008, but not taking effect until 2010 requires insurance to cover mental health illnesses.

Unfortunately, the guidance from parity regulators has so far not been specific or clear enough, allowing some insurers to hide behind a level of vagueness. Until enforcement of the parity law, and until there is an effective definition of what parity protections there are, it's possible that even under Medicaid insurers are free to delete some of these essential treatment services.

Many in the American Psychiatric Association say that there is too much not spelled out in the law and until the APA and Parity regulators determine a clear definition, some insurance groups will continue to interpret the law to their benefit. Are they right? Yes, as there are legitimate differences of opinion even among the APA and parity regulators that need to be resolved.

Until the federal agencies responsible for regulations of the parity law finalize clear definitions for the scope of services, insurance groups will continue down the path of their choice. At present there is no one that can definitively say that an issue in your health plan is clearly out of compliance, and that another issue may be in compliance. At present there is confusion at all levels.

So at present, the medical insurance companies will continue doing their thing and patients may suffer the consequences. Read the article here. There are some real problems to be resolved.

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