The American Psychiatric Association (APA) has hailed the interim rules for implementing parity for fairness in insurance coverage for individuals with mental illness and substance use disorders, but feels some important issues must still be resolved.
"Mental health parity was a major advance for the APA and for our patients living with mental illnesses," said APA President Alan F. Schatzberg, M.D.
In a statement, the Association said that it was reviewing and analyzing the newly announced regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
The law applies to employers with 50 or more workers whose group health plan chooses to offer mental health or substance use disorder benefits. The Act requires that any group health plan that includes mental health and substance use disorder benefits ensure that the benefit is no more restrictive than medical and surgical coverage in terms of out-of-pocket costs, benefit limits and practices such as prior authorization and utilization review.
Welcoming the law, the Association said the requirement for a single deductible for mental health and medical/surgical coverage was also welcome.
Patients with mental illness often have general medical conditions that require treatment at the same time. Separate deductibles prevent access to mental health treatment. Hence the APA had strongly advocated for combined deductibles and was pleased with the response of the Departments of Health and Human Services, Labor and Treasury the Departments to its suggestions.
"While there are many positive aspects of the regulation, there are areas that the Departments did not address. The Departments are soliciting additional comments on issues such as provider networks and formulary development. APA intends to provide additional input on these and other issues during the open comment period," the statement added.
During the 90-day comment period, the APA will receive a full legal analysis of the rule and talk frequently with Congressional leaders, employers and other mental health groups to prepare a response, the statement adds.