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Mental Health Parity Act ends discrimination
New law requires fair insurance coverage of mental health

as part of the Emergency Economic Stabilization Act


 

Have you read these?

 

People living with mental health conditions have long seen their health plans limit visits to mental health professionals and hospital stays and charge higher co-payments than those for their other medical coverage.  But a bill to end insurance discrimination against Americans with mental health conditions in employer-sponsored health plans was passed into law as part of the economic recovery act on Oct 3.

The landmark mental health parity law, which has been signed by President Bush, will allow more than one-third of all Americans to receive equal coverage of mental and physical illnesses. It will require group health insurance plans to cover mental illnesses, such as major depression, bipolar disorder and schizophrenia, and substance abuse disorders on the same terms and conditions as other illnesses.

The law is projected to be effective for most health plans as of January 1, 2010. It will provide parity for 82 million Americans covered by self-insured plans and another 31 million in plans that are subject to state regulation. 

What are the new requirements?
The legislation applies to group health plans of 51 or more employees and specifies that if mental health coverage is offered, it must be equal to medical coverage, prohibiting treatment limitations and stricter financial requirements. However, there is no requirement as to what conditions must be covered. If a plan offers out-of-network benefits for medical or surgical care, it must also offer out-of-network coverage for mental health and addiction treatment and provide services at parity.

Existing state laws, which may provide broader coverage, also apply. (The National Alliance on Mental Health explains individual state laws. Scroll list.)

The legislation also establishes an important oversight mechanism to determine if insurers are discriminating against certain conditions or failing to cover some treatments.

Cost Exemption: A health plan is allowed to be exempted from the federal parity law if it can prove that parity is raising its total plan costs by more than 2 percent in the first year after enactment of the parity law and 1 percent thereafter. But plans must first implement parity for at least six months. 

 

 

 

US capitol“A great civil rights victory,” the advocacy organization Mental Health America calls this historic reform.  “With approval of this bill, we will tear down the walls of stigma and discrimination and open the doors to the power and promise of treatment and recovery,”  said David Shern, Ph.D., president and CEO of Mental Health America. “It recognizes that mental health disorders are every bit as debilitating, and just as treatable, as cancer and diabetes… This law sends a powerful message that we as a nation must address mental health conditions with the same urgency as other health problems,” he said. 

The new law, the Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, is the result of tireless advocacy by organizations such as the National Alliance on Mental Illness and Mental Health America and the bipartisan effort in Washington of sponsors Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), as well as Senators Pete Domenici (R-NM), Ted Kennedy (D-MA), and Mike Enzi (R-WY).

 

For more information
Mental Health America
National Alliance on Mental Illness
Senator Pete Domenici (R-NM)
Senator Ted Kennedy (D-MA)

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Page updated November 1, 2008