New bill would improve parity enforcement and consumer protections
The APA Practice Organization (APAPO) sent a Dec. 17 letter (PDF, 74KB) to Rep. Joe Kennedy III, D-Mass., in support of the Behavioral Health Coverage Transparency Act of 2015 (HR 4276). Introduced Dec. 16, 2015, the legislation would strengthen the federal parity law, the Mental Health Parity & Addiction Equity Act of 2008, by increasing enforcement and oversight. The bill would also give consumers better access to information that will allow them to understand and assert their rights under the law.
If passed, the act would strengthen parity compliance, implementation and transparency in various ways, by requiring:
- Federal regulators to conduct random audits of insurers and plans for parity compliance.
- Federal parity agencies (The departments of Health and Human Services, Labor and Treasury) to review denial rates for mental health claims as compared to medical claims.
- The creation of a central online portal established by the secretary of the Department of Health and Human Services where consumers can access information, and submit complaints and violations.
- The Government Accountability Office to publish a report on the federal parity agencies’ enforcement efforts which will include number of investigations and audits conducted as well as details of those investigations and enforcement actions.
- Insurance companies to provide an annual report detailing their parity analysis, particularly with respect to the nonquantitative treatment limitations, which have been a concern for psychologists and their patients.
“APAPO, along with other mental health stakeholders, has been advocating for years for better implementation and enforcement of the law,” says APAPO Executive Director for Professional Practice Katherine C. Nordal, PhD. “It is long past time for patients to realize the end of health insurance discrimination for mental health and substance abuse coverage.”
APA and APAPO have been working to address parity and discriminatory health insurance coverage for nearly two decades. After passage of the Mental Health Parity Act of 1996, APA urged federal lawmakers to close loopholes in that act and finally make insurance coverage of mental health benefits truly equal to coverage of physical health benefits. APAPO, a companion to APA, took up the call for parity when the organization was created in 2001.