Sunday, November 16, 2008

Mental Health Parity Law

Included as part of the recent financial rescue/bailout bill signed by President Bush, was the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. This will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. This means that equity in coverage will apply to all financial requirements, including lifetime and annual dollar limits, deductibles, copayments, coinsurance, and out-of-pocket expenses, and to all treatment limitations, including frequency of treatment, number of visits, days of coverage and other similar limits.

The new law will go into effect on 1/1/10, in order to give insurance companies time to change their policies. Medicaire and Medicaid are exempt. Medicare co-payments for mental health services are currently at 50%, while medical co-payments are at 20%. However, a Medicare parity bill passed last summer, so in 2014, mental health co-payments will be reduced to 20%. This bill was vetoed by President Bush, but the Congress overwhelmingly overrode the veto.

Forty-three (43) states have enacted parity laws. While some of these laws provide for strong parity protections, most are not as comprehensive as the new federal law.

Parity will not effect the millions of Americans who are still uninsured.

Best wishes,

Mike

1 comment:

Daniel Guarnera said...

Dr. Miller,

So far I've enjoyed your blog a great deal. Just one quick point of correction on your last post--Medicaid plans do fall under the new parity law. The Wellstone-Domenici Parity Act applies to both ERISA (self-insured) plans, which had not been subject even to state parity laws previously, and state-regulated plans (including Medicaid). About 113 million Americans are enrolled in plans that will be affected by the new parity law.

Keep up the good work!

Daniel

P.S.: I blog on addiction treatment and advocacy issues at www.addictionpro.com--it often seems like there isn't a true interactive "blogosphere" for mental health and addiction bloggers yet, so we're always trying to reach out and make contact!

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