Mental Health Parity News

Senators Ted Kennedy (D Mass.), Mike Enzi (R Wyo.) and Pete Domenici (R N.M.) announced today a bipartisan improved mental health parity bill that the Senate Health, Labor, Education, and Pensions Committee will consider in executive session on Wednesday February 14, 2007, at 9:30 am. (Sens. Kennedy and Enzi are the chair and ranking member of the HELP Committee.) According to the press release,

The legislation would provide mental health parity for about 113 million Americans who work for employers with 50 or more employees. It will ensure that health plans do not place more restrictive conditions on mental health coverage than on medical or surgical coverage. As such it would require:
· Parity for financial requirements like deductibles, co-payments, and annual and lifetime limits; and,
· Parity for treatment limitations such as the number of covered hospital days and visits.

The 1996 Mental Health Parity law only provided parity for annual and lifetime limits between mental health coverage and medical surgical coverage. The new bill expands parity by including deductibles, co-payments, out-of-pocket expenses, coinsurance, covered hospital days, and covered out-patient visits.

The bill would not prohibit group health plans from negotiating separate reimbursement or provider payment rates, or managing the provision of mental benefits in order to provide medically necessary treatments under the plan (as a means to contain costs and monitor and improve the quality of care).

This is similar to the improved mental health parity program that has been utilized by the Federal Employees Health Benefits Program since 2001. However, the press release states that “Oversight and administration would be conducted by the Department of Labor for self funded ERISA plans and by the Department of Health and Human Services for insured plans.” Where would FEHB plans fit in here? Oversight over those plans should remain with OPM.