What The "Final Rules" Really Mean
Last month, the mental health community celebrated as the Department of Health and Human Services (HHS) issued the "Final Rule" for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act (MHPAEA). Parity was signed into law by President George Bush in 2008. After five years of deliberation, and after five years of battling parity violations for our clients, this news came as a breath of fresh air. The "Final Rule," at long last details how insurers must offer coverage for mental health and substance abuse treatment. Furthermore, the "Final Rule" provides for increased transparency and compliance with the law, and increased access to mental health treatment for those suffering with mental illness and addition.
While the "Final Rule" brings excellent news, the battle now shifts to ensuring implementation and enforcement of MHPAEA. At a recent meeting (of more than 35 groups representing psychiatry, addiction medicine, social work, psychology, patient-advocacy groups and other medical fields) former Congressman Patrick Kennedy explained the battle ahead, "Until this is written into the hearts and minds of practitioners across the whole spectrum of mental health and substance use, and until it is written into the hearts and minds of the American people that this is something they should expect when they seek care, then we still have work to do..."
Unfortunately, the "Final Rule" does not currently apply to the Children's Health Insurance Program (CHIP) or to Medicaid or alternative benefit plans, such as Medicaid expansions – which is particularly sad because Medicaid is the biggest insurer for people suffering with mental health problems.
Despite its limitations, the "Final Rule" is a tremendous triumph for the mental health field, as it marks an important beginning for eliminating the discrimination and stigma against those who suffer from mental illness, as well as paving the way to creating more accessible treatment and restored health and wellbeing.
We will continue to work towards safeguarding parity- and challenging parity violations- as the fight to ensure parity continues. If you feel that your insurance company has violated parity, please do not hesitate to contact Kantor & Kantor, LLP for a no cost consultation.
We understand, and we can help.