Washington, DC- On the 50th Anniversary of the signing of President Kennedy’s groundbreaking mental health law, U.S. Senator Bob Casey (D-PA) called on the Office of Management and Budget to finalize regulations implementing the 2008 mental health parity law. When finalized, the rules will fully implement a law that prevents insurance companies from discriminating against those with a mental illness.
“President Kennedy was ahead of his time on the issue of mental health. It’s critical that we continue that legacy today,” Senator Casey said. “Finalizing these rules will help more Americans access mental health care at the same level as other health benefits. I’m hopeful that the Administration will quickly move towards full implementation of the legislation we passed in 2008.”
In 2008, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, taking a great step forward in the decade-plus fight to end insurance discrimination against those seeking treatment for mental health and substance use disorders. This law requires health insurance to cover both mental and physical health equally. Under this law, insurance companies can no longer arbitrarily limit the number of hospital days or outpatient treatment sessions, or assign higher co-payments or deductibles for those in need of psychological services.
The 2008 act closes several of the loopholes left by the 1996 Mental Health Parity Act and extends equal coverage to all aspects of health insurance plans, including day and visit limits, dollar limits, coinsurance, co-payments, deductibles and out-of-pocket maximums. It preserves existing state parity and consumer protection laws while extending protection of mental health services to 82 million Americans not protected by state laws. The bill also ensures mental health coverage for both in network and out-of-network services.
The text of Senator Casey’s letter can be found below:
Ms. Sylvia Matthews Burwell
Office of Management and Budget
Dear Director Burwell:
I understand the Administration is finalizing a final rule implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
I thank you for you work to finalize this important regulation, and I urge you to do so as quickly as possible. Promptly releasing the final rule is critical because my constituents report they are still having trouble accessing mental health and addiction benefits at parity with other medical conditions.
Although the MHPAEA Interim Final Rule (IFR) has been in effect since January 1, 2011, without the final rule, equal access to mental health and substance use services will continue to lag. Specifically, there are three issues that I hope will be clarified in the final rule:
- First, the final rule must provide guidance on whether plans must offer a comparable scope and range of medical and behavioral health services, including equitable access to addiction medicine physicians and treatment medications.
- Second, plans must be required to disclose the criteria and the applications used to make benefit determinations on both medical and surgical conditions and behavioral health conditions. This information is necessary to assess whether the plan is in compliance with the law.
- Third, the rule must provide greater clarity regarding non-quantitative treatment limitations in order to allow for enforcement actions against inequitable treatment limitations, such as discriminatory prior authorization requirements.
I hope the final rule will be released as soon as possible and will address these important gray areas so individuals across the country can access the benefits promised to them under the law.
Robert P. Casey, Jr.
United States Senator
The Honorable Jack Lew
The Honorable Kathleen Sebelius
The Honorable Thomas Perez