Biden Administration’s New Rules Seek to Hold Insurers Accountable for Mental Health Protection
The Biden administration announced Monday that it has finalized new regulations to strengthen protections for mental health coverage and hold insurance companies accountable for denying them.
The legislation updates the Mental Health Parity and Addiction Equity Act, which was passed in 2008, which requires health insurance plans to provide the same access to mental health care as medical care. The new provisions will force health insurance plans to collect and report robust data on how they reduce and deny mental health claims. If there is no separation between psychiatric and medical care, insurers will need to plan how they try to address these gaps.
“Mental health care is health care. But for too many Americans, intensive care and treatment are not possible,” President Joe Biden said in a press release announcing the final rules. “There is no reason that a broken arm should be treated any differently. than having a mental health condition.”
The revised rules seek to address a problem identified in numerous studies and reports and explored with new data in a recent ProPublica investigation.
Although nearly all Americans have health insurance, millions still lack access to mental health care. ProPublica found that insurance companies have interfered with patient care, used aggressive assessments and set reimbursement rates so low that providers feel they have no choice but to leave the network. insurance. Our reports also document how serious the consequences can be when patients do not receive medical or psychiatric treatment.
Federal regulators have been cracking down on police insurance companies. Almost all of the recent reports the Labor Department collected from insurers and health plans did not contain enough information to determine whether the companies were in compliance with the law, the department reported. Congress last year. Some states have passed laws to close information gaps, but we’ve found mental health protection often depends on where a person lives.
The new rules require insurers to collect and report outcome data, such as denial rates, to measure how often patients receive care. Companies will have to disclose information about insurance networks, which could include how often patients come out of the network for mental health treatment and how reimbursement rates are calculated for providers. of mental health.
The laws also specify that patients have the right to access this information and require insurers and health plans to provide reports within 30 days of a request.
U.S. Rep. Virginia Foxx, RN.C., who chairs the Education and Labor Committee, said the rules are too onerous. “These laws do nothing to improve access to mental health care and instead place burdens on patients,” he said in an emailed statement.
But former US Representative Patrick J. Kennedy, who sponsored the 2008 parity bill and founded the mental health advocacy nonprofit The Kennedy Forum, said the new laws would protect patient access. “This is an opportunity for consumers to finally have a seat at the table,” he told ProPublica.
The law applies to 175 million people who have health insurance. Under the new regulations, this coverage will cover people with health insurance through state and local governments, which is an additional 120,000 Americans.
The finalized rules came after a year-long review process, where three departments – Treasury, Health and Human Services, and Labor – collected thousands of public comments. Departments had begun publishing the proposed rules in August 2023. Some of the provisions will go into effect on January 1, said Lisa Gomez, assistant secretary of labor for security benefits at the Department of Labor.
“People living with mental health conditions and substance use disorders still face significant barriers,” he said. “That’s not fair, it’s not right and it’s against the law.”
#Biden #Administrations #Rules #Seek #Hold #Insurers #Accountable #Mental #Health #Protection