KENNEDY INTRODUCES BILL TO HOLD INSURERS ACCOUNTABLE FOR MENTAL HEALTH COVERAGE
Washington, D.C. – Congressman Joe Kennedy III introduced the Behavioral Health Coverage Transparency Act of 2015, which will hold health insurers accountable for providing adequate mental health benefits and increase transparency for consumers seeking coverage for mental illness and substance use disorders.
Under current federal law, most insurance plans must provide mental health coverage on par with the coverage they provide for other medical or surgical services, a requirement known as “parity.” However, adherence to existing parity laws has been weak and inconsistent. According to a recent National Alliance on Mental Illness report, insurers denied authorization for mental health care at nearly twice the rate they did for medical care, often providing no information about the criteria used to make the decision. A separate survey of 84 major health plans found that only 15 made detailed plan documents outlining the scope of their mental health coverage available to consumers.
“Too many Americans suffering from mental illness are unable to access the treatment they need because their insurance company refuses to cover it – oftentimes with no explanation at all ,” said Congressman Kennedy. “By boosting transparency and giving consumers more information, this bill would ensure insurance providers treat mental health and substance use disorders the same way they would a broken leg or heart disease. As we work to fill systemic gaps in our mental health system, holding insurers accountable for providing adequate mental health coverage is critical.”
The Behavioral Health Coverage Transparency Act would require insurance issuers to disclose annually to federal regulators the analysis they perform in making parity determinations as well as the rates and reasons for mental health claims denials versus medical/surgical denials. It also would require the Department of Health & Human Services, the Department of Labor and the Department of Treasury to undertake a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws. Finally, it would establish a Patient Parity Portal, allowing consumers to easily access all publicly available parity information and submit complaints in a central online clearinghouse.
The legislation has received support from the following advocacy and expert organizations: American Foundation for Suicide Prevention/SPAN USA, American Psychiatric Association, American Psychological Association, Bazelon, Eating Disorders Coalition, Kennedy Forum, Legal Action Center, National Alliance to Advance Adolescent Health, NAMI, National Association for Children's Behavioral Health, National Disability Rights Network, Massachusetts Medical Society, Parity Implementation Coalition.
Since being elected, Congressman Kennedy has been a vocal advocate for enforcement of mental health parity laws, expanded access to substance abuse treatment, and an improved reimbursement system for providers. Recently, Congressman Kennedy urged federal agencies reviewing the proposed mergers of several large health insurance companies to carefully consider the impact of those consolidations on access to mental health and substance abuse treatment. To read the full letter, please click here.
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For Immediate Release:
December 17, 2015
Emily Kaufman (617) 332-3333
Dan Black (202) 225-5931
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