Rules that will require health insurers to provide coverage for addiction and mental health that is equal to benefits for general medical coverage will be issued Friday by the Obama administration, The New York Times reports.
The regulations will apply to almost all forms of insurance. They will be announced by Secretary of Health and Human Services Kathleen Sebelius at a mental health conference in Atlanta. Administration officials say the rules will ensure that health plans’ co-payments, deductibles and limits for visits to health care providers are the same for addiction and mental health services as they are for medical and surgical benefits—referred to as “parity.”
The rules will put into effect the 2008 Mental Health Parity and Addiction Equity Act. They are expected to spell out how parity applies to residential treatment centers and outpatient services, used by many of the people receiving addiction and mental health treatment. For example, a health plan will not be able to restrict patients to in-state substance abuse treatment, while allowing them to go anywhere for medical or surgical treatment.
The regulations will affect people covered by health policies offered by employers or other group plans, or coverage bought in the market for individual plans, the article notes. They do not cover people covered by Medicaid, but the administration has previously issued rules telling state health officials that Medicaid plans should meet the requirements of the 2008 parity law. The law also does not apply to Medicare.
Primary responsibility for holding commercial insurance companies to the parity standards will fall to state insurance commissioners, who are already enforcing new insurance market rules. “We need enforcement,” former Representative Patrick J. Kennedy of Rhode Island, a co-sponsor of the 2008 parity law, told the newspaper. “The notion of delegating this to the states, which are looking to the federal government for direction, is problematic.”