APA Endorses New Parity Enforcement Legislation, Urges Speedy Passage

APA has endorsed the Mental Health Parity Compliance Act, a bipartisan bill introduced in the Senate last month that would enhance the transparency and accountability of insurers’ coverage of mental and substance use disorders in compliance with the federal parity law.

That law, the Mental Health Parity and Addiction Equity Act of 2008, requires health plans to cover mental and substance use disorders the same as other medical illnesses; however, there is a lack of oversight to ensure that patients are receiving equal coverage of psychiatric conditions under the law. Plans that are subject to the Employee Retirement Income Security Act of 1974 (ERISA), or self-funded employment plans, are outside the enforcement jurisdiction of state agencies. The new legislation, co-sponsored by Sen. Chris Murphy (D-Conn.) and Sen. Bill Cassidy (R-La.), will tighten parity enforcement of these ERISA plans.

“For too long insurers have neglected their responsibility to adequately provide coverage for patients with mental illness or substance use disorders,” said APA President Bruce Schwartz, M.D. “This bill will help to ensure those patients be treated like patients with any other illness and end this harmful discrimination.”

Insurers have used a variety of means to sidestep the parity law and reduce utilization of mental health services, including inadequate reimbursement rates for psychiatrists and mental health professionals and “skinny” networks; the latter refer to health insurance provider networks that have few mental health professionals available to treat patients. In some cases, health plans have been found to have “phantom networks” that include physicians who are no longer accepting patients, have moved out of a geographic area, or are deceased.

“We wholeheartedly support this bill, and we urge the Senate and the House to take this up soon and pass it,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “Our patients depend on insurance for their care.” ■