Insurers Seek to Limit Scope of Federal Parity Regulations
The 2008 federal addiction and mental-health parity law is under attack by insurance companies that want the Obama administration to delay implementation of the regulations and change some of the rules designed to ensure that behavioral-health problems are treated on par with other diseases, the New York Times reported May 9.
Insurers contend that the rules issued by the administration go beyond the intent of Congress in passing the parity law, would inhibit their ability to control costs, and could raise patients’ out-of-pocket expenses.
The law bans caps on the number of days spent in treatment if such limits don’t apply to other forms of healthcare services, but insurers are objecting to the administration’s efforts to control such “nonquantitative treatment limits” as managed-care guidelines, selection of providers, and reimbursement rates. Another bone of contention is a call for insurers to set a single deductible for all health services rendered, not separate deductibles for behavioral-health and general-health services.
Insurers like Aetna and the Blue Cross and Blue Shield Association said the law was not intended to ensure parity in reimbursement, but advocates for addiction and mental-health services said that access to treatment has been limited by insurers low payment rates for providers. American Psychiatric Association CEO James H. Scully Jr. said that some insurers have tried to skirt the law by “imposing new requirements for prior authorization and the submission of treatment plans for mental health services where there were no comparable requirements on the medical-surgical side.”