Mental Health Parity Redux

[somarco]

Mental health parity in health insurance has been tried and failed multiple times. So what do the rocket surgeons in DC want to do? Try again. It must be an election year . . .



Congress first passed the Mental Health Parity Act in 1996. Lawmakers amended the law in 2008, and again in 2020, partly for the purpose of giving federal regulators more tools to enforce compliance.

One study cited by White House aides showed people with health insurance are more than twice as likely to seek out-of-network care for mental health conditions than for physical health conditions.

The new rule would attempt to crack down on some health insurers' more subtle tactics, too, like offering lower rates to out-of-network mental health providers or imposing prior authorization requirements for mental health care at a higher rate than for most physical health services or procedures.

[EXTERNAL LINK] - White House unveils plan to make insurers cover mental health care


This approach ignores the fact that a large number of mental health practitioners operate strictly on a pay as you go basis and do not accept insurance assignment.

 

[qureshia110]

Mental health parity in health insurance has been tried and failed multiple times. So what do the rocket surgeons in DC want to do? Try again. It must be an election year . . .



Congress first passed the Mental Health Parity Act in 1996. Lawmakers amended the law in 2008, and again in 2020, partly for the purpose of giving federal regulators more tools to enforce compliance.

One study cited by White House aides showed people with health insurance are more than twice as likely to seek out-of-network care for mental health conditions than for physical health conditions.

The new rule would attempt to crack down on some health insurers' more subtle tactics, too, like offering lower rates to out-of-network mental health providers or imposing prior authorization requirements for mental health care at a higher rate than for most physical health services or procedures.

[EXTERNAL LINK] - White House unveils plan to make insurers cover mental health care


This approach ignores the fact that a large number of mental health practitioners operate strictly on a pay as you go basis and do not accept insurance assignment.

Mental health parity is a complex issue. While the intent is good, the practical implementation often falls short. Strict enforcement and addressing the unique challenges faced by out-of-network providers are crucial for effective implementation.

 

[somarco]

@qureshia110 the big challenge for MHC payers is the sometimes ambiguous and subjective approach to diagnosing and treating the condition.

Unlike physical ailments that are revealed by scans, lab tests and biopsies . . . MH conditions are mostly based on observation which fail to provide evidence that meets the medically necessary definition.