It is currently Tue Aug 22, 2017 12:00 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 4 posts ] 
Author Message
PostPosted: Fri Nov 08, 2013 11:32 am 
Offline
Average Poster
Average Poster

Joined: Tue Jul 09, 2013 7:08 pm
Posts: 8
Watch Today's Web Briefing on Final Rule on Mental Health and Substance Use Disorder Parity
Friday, November 8, 2013 | 12:30 p.m. Eastern Time

Mental Health Parity and Addiction Equity Act (MHPAEA),
This is important because it changes the way that insurance companies must cover substance abuse and mental health disorders... they can no longer discriminate with benefits... if they cover for other illnesses they must cover for substance abuse and mental health in an equitable way.
Watch Today's Web Briefing on Final Rule on Mental Health and Substance Use Disorder Parity
Friday, November 8, 2013 | 12:30 p.m. Eastern Time

Today, the U.S. Departments of Health and Human Services (HHS), Labor (DOL), and the Treasury are jointly issuing the final rule to implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA), and ensure that health plan features such as co-pays, deductibles, and visit limits are generally not more restrictive for mental health/substance use disorders benefits than they are for medical/surgical benefits. The final rule will be posted on the Federal Register website by 11:15 a.m. EST.

Today's action also includes specific additional consumer protections, such as:

Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings
Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law
Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits, and network adequacy
Eliminating an exception to the existing parity rule that was determined to be confusing, unnecessary, and open to abuse.
As time permits, participants may ask the speakers questions by calling the toll-free dial-in number: 800-988-9672 and using the Conference ID: HHS.

Watch the Web Briefing | View the MHPAEA Factsheet

Web Briefing Speakers

Pam Hyde, Administrator, SAMHSA (HHS)
Amy Turner, Senior Advisor, Office of Health Plan Standards and Compliance Assistance (DOL)
Daniel Maguire, Director, Office of Health Plan Standards and Compliance Assistance (DOL)
James Mayhew, Director, Market Rules Division, Center for Consumer Information and Insurance Oversight (HHS)
Suzanne Fields, Senior Advisor for Health Care Financing, SAMHSA (HHS)
Kirsten Beronio, Director, Division of Behavioral Health and Intellectual Disabilities Policy, Office of the Assistant Secretary for Planning and Evaluation (HHS)


Like SAMHSA on Facebook Follow SAMHSA on Twitter Subscribe to SAMHSA's YouTube Channel Visit the SAMHSA Dialogue Blog




Substance Abuse & Mental Health Services Administration
1 Choke Cherry Road | Rockville, MD 20857
1-877-SAMHSA-7 (1-877-726-4727) | http://www.samhsa.gov | Privacy

United States Department of Health and Human Services
SAMHSA is a public health agency within the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America's communities.


Top
 Profile  
 
PostPosted: Sun Nov 10, 2013 5:55 pm 
Online
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4133
Thanks for the information! I'm wondering if you could give examples of the practical ways this will change what a substance abuse patient goes through with insurance? I read the ways in which the changes will offer better consumer protection, but I don't understand the previous practices and therefore I don't know how consumer protection will improve in practical ways.

Thanks,

Amy

Moderator

_________________
Done is better than perfect!


Top
 Profile  
 
PostPosted: Sun Nov 10, 2013 6:41 pm 
Offline
Average Poster
Average Poster

Joined: Tue Jul 09, 2013 7:08 pm
Posts: 8
Hi there:

I am no expert on the subject but I can only give you an example of how I believe this will change things.

When I go to the Psychiatrist today for a mental health issue (for example) depending on how the doctor codes the visit (diagnosis code) to the insurance company, my insurance has limitations on how many times I can see a physician for this (mental) health issue. (Many mental health diagnosis codes are limited by insurance, in this example, I can only seek mental health counseling 7 times per year before they want more documentation (and may refuse coverage) without it. If you have mental illness - they restrict benefits for certain services.

As I read this - they can no longer out single out mental health visits like this. If you have a heart disorder, you can see the heart doctor as much as is necessary (within reason). If you have mental issue and need to seek a doctors help, you should be able to do so without worrying whether or not they are restricting benefits (i.e., number of visits) for this type of illness.

Insurance companies put restrictions on the services that are available for people with this disease but maybe not on another disease.

Here they are referring to parity between mental health/substance use disorders benefits vs. medical/surgical disorders benefits.

I believe this as a parity issue - fairness. Mental health is an illness like any other, so the benefits they provide for one illness (med/surgical)- they must provide for another (mental health) illness as well.

For years, insurance companies have restricted mental health coverage. Hopefully I am reading this correctly and access to care for this disease will be as comprehensive as it is for other diseases.

I'm sure there are others here with mental health issues that can point to gaps or limitations on their own coverage. It's about time that this is changed.



T.


Top
 Profile  
 
Our Sponsors
PostPosted: Mon Nov 11, 2013 2:04 am 
Online
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4133
Thanks so much for laying that out there for me and everyone else! If anyone else cares to comment, please do so!

Amy

Moderator

_________________
Done is better than perfect!


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 4 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group