FRIDAY, Nov. 8 (HealthDay News) -- U.S. health officials
unveiled long-awaited rules Friday that require insurance companies
to cover treatment for mental illnesses and addiction the same way
they cover physical illnesses.
Secretary of Health and Human Services Kathleen Sebelius, who
announced the regulations at a health conference in Atlanta, said
this is "the largest expansion of behavioral health benefits in a
The regulations will make the 2008 Mental Health Parity and
Addiction Equity Act a reality, and fulfill a generation-long
effort to improve benefits and treatment for people with mental
health issues or substance abuse problems.
Co-pays, treatment limits and deductibles can't be more
stringent for people with mental illness than for people with a
physical illness, under the new rules. This means insurance
providers "can't say you can only get substance-abuse treatment in
state but you can go anywhere for medical/surgical" treatment, a
senior Obama administration official told
The New York Times, which broke the story on Friday.
Nor can insurers deny coverage for someone with a history of
depression, attention-deficit/hyperactivity disorder, anxiety or
other common conditions, mental health experts said.
An estimated one-quarter of Americans have some form of mental
illness, according to the U.S. Centers for Disease Control and
This "incredibly important law, combined with the Affordable
Care Act, will expand and protect behavioral health benefits for
more than 62 million Americans," Sebelius said. "People who either
have insurance coverage now and have no mental health coverage or
where the Affordable Care Act fills in those gaps for people who
have no insurance at all, they will be able to access affordable
Mental health advocates welcomed Sebelius' announcement.
People with mental illness have long faced discrimination in
health care through unjust and often illegal barriers to care, Dr.
Jeffrey Lieberman, president of the American Psychiatric
Association, said in a statement. This final rule "provides a
crucial step forward to ensure that patients receive the benefits
they deserve and are entitled to under the law," he said.
Lieberman added he is hopeful there will be strong monitoring
and enforcement of the law by states and the federal
Dr. Victor Fornari, director of the division of child/adolescent
psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y.,
said, "We have been fighting for parity for a very long time."
The way Fornari views it, "Every effort to have increased access
to health care, including mental health care, is progress in a
The rules will affect most Americans with health insurance,
including health plans bought under the Affordable Care Act of
2010. However, the regulations may not apply to people covered by
Medicaid, the publicly funded insurance program for the poor, or
Medicare, which provides coverage for seniors, the
Simon Rego, director of psychology training at Montefiore
Medical Center/Albert Einstein College of Medicine in New York
City, said the effects of the new rules will be wide-reaching.
"Ultimately issuing these regulations is a wise investment that should pay dividends down the road in terms of improved quality of life for the population and cost-savings for the insurers," said Rego.
"We in the mental health field have known for some time that providing patients with mental health and substance abuse disorders the care they need can have tremendous benefits in a number of other key areas," he said. Decreased absenteeism and increased productivity at work, greater satisfaction in relationships and housing situations, and more successful treatment of physical/medical illnesses are just some of these benefits, Rego said.
While Fornari applauded the effort to attain parity, he said he
was concerned that improved access to mental health care might
strain the system. "We do not have enough mental health
practitioners in the country," he said.
"At least this would allow people the equal possibility to seek care, and now the question is going to be finding the appropriate care," he added.
Expanding access to mental health coverage is also part of
President Obama's strategy for reducing gun violence in the United
States. In the wake of the mass shootings last year in Connecticut
and Colorado, the Obama administration sought support to improve
mental health benefits as part of the effort to curb killings.
Former Rep. Patrick Kennedy of Rhode Island, son of the late
Sen. Ted Kennedy of Massachusetts, co-sponsored the 2008 law. He
said the rules will also provide much-needed help to veterans "for
the invisible wounds they have brought home from Iraq and
Afghanistan," according to the
The U.S. Centers for Disease Control and Prevention has more
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Information Services. All rights reserved.