Wednesday, March 3, 2010

Mental Health Parity Law - Is It Working?

The American Psychiatric Association has created a website,, about the 2008 Mental Health Parity Act
(The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008). The purpose of the site is to educate consumers and
physicians about the Act and to monitor the implementation of this new law.

The Parity Act

The parity legislation and its regulations are complicated. The Act requires
that any group health plan that covers more than 50 employees and offers
mental health and/or substance use disorders coverage must provide that
coverage with no greater financial requirements (i.e., co-pays, deductibles,
annual or life-time dollar limits) or treatment limitations (i.e., number of
visits) than the predominant requirements that it applies to substantially
all medical/surgical benefits.

Monitoring Implementation - Your Input Can Help

You and your members are encouraged to go to the site to learn more about
the Parity Act and state parity laws and to report concerns and questions
about how an insurance plan may be interpreting the law.
Please spread the word about the website. The more people who understand
parity and the more reports received, the better.

The only way we can know if the law is being implemented correctly is if we
hear from patients and their physicians about problems or concerns they may
have about a health plan's mental health coverage given the Parity Act's
requirements. Your reports will help us identify areas of concern that will
be passed along to federal regulators.

The Website

The American Psychiatric Association's (APA's) new website has information
* What is involved in filing an insurance claim when benefits have
been denied
* Where to file a complaint
* When an external review is warranted
* What it means to file an ERISA claim
* How state laws relate to the federal law

Visit the web site and call (866)
882-6227 to report concerns.

For more information, contact Samantha Hawkins in the APA's Office of
Healthcare Systems and Financing, (703) 907-8612

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