As we described in an earlier article, the U.S. Department of Health and Human Services recently released new rules enforcing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, a 2008 law compelling insurers to treat mental illness on an equal footing with other illnesses. In the month since the new regulations went into effect, several insurance companies have complained that the regulations go too far in their attempt to limit how insurance companies select and reimburse providers and manage care.
The major source of the companies' dispute with the government is that the recent federal regulations place restrictions on how the insurance companies can or cannot reimburse physicians, and the insurance companies claim that those regulations significantly overstep the goals of the law. Advocates for people with mental illness have taken the opposite view, pointing out that without government regulation, insurance companies may choose to slash payments to physicians who provide mental health services, leading those physicians to stop treating patients who desperately need care.
Insurers have also taken aim at regulations that require insurance plans to offer a single deductible for all services, instead of having separate deductibles for mental health services and non-mental health services. The companies have stressed that combining all of a patient's care under one deductible leads to higher costs, but some legislators who were instrumental in passing the initial law have supported the new regulations, reiterating that the intent of mental health parity legislation was to end the separate treatment of mental illness. Neither side appears ready to compromise, and at least some industry leaders have taken the next step in this continuing dispute by filing a lawsuit seeking to overturn some of the new regulations.
To read a New York Times article discussing the current dispute, click here.Article Last Modified: 11/19/2014
© 2017 ElderLawNet, Inc.