Blog | Friday, July 11, 2008

A new day for mental health parity


Last September, we wrote a story about how the House and Senate were each crafting bills to require that employers and insurers institute mental health parity-- coverage for mental health equal to that of physical health (a flawed definition, I realize, because it implies the two are discrete).

Well, it appears the two sides have reached a compromise on a bill. According to the WSJ, its components include:

  • Employers who offer mental health coverage must make it equal to physical health coverage, meaning they cover the same number of doctors' visits and hospital stays, and require the same co-pays and deductibles. (The 1996 parity law already requires that annual and lifetime dollar limits be equal for mh and physical health) Out-of-network coverage, if offered, must be the same as well.
  • It doesn't require employers to offer mental health coverage, however. Basically, if you offer it, you have to offer it all the way...or not at all.
  • Employers with 50 or fewer employees are exempt from parity requirements.
  • It doesn't mandate which specific mental illnesses are covered.

The recently-passed Medicare bill (you know the one, right?) included a provision that would gradually reduce the existing 50% copays for Medicare patients' mental health services to 20%-- the current copay for physical services. Experts hope that not having to chase down patients for half the bill will encourage more psychiatrists (which are in short supply) and psychologists to accept Medicare patients.