The Biden administration has announced sweeping new rules meant to push insurance companies to boost their coverage of treatments for mental health problems and substance use disorders.
The proposed new rules were announced by the White House on July 25 and are expected to be published in the Federal Register within weeks, after which they will be subject to a 60-day public comment period before becoming law.
The White House said in a statement that the new rule “would improve and strengthen mental health parity requirements and ensure that more than 150 million Americans with private health insurance can better access mental health benefits under their insurance plan.”
The proposed rule focuses on enhancing insurer compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, which required insurers to provide the same level of coverage for both mental and physical health care.
The Biden administration believes there are problems with the implementation of and compliance with the MHPAEA as insurance policies restrict access to mental health benefits in various ways.
“Too many Americans still struggle to find and afford the care they need,” the White House said in a statement, citing data that show there are ongoing barriers to mental health and substance use disorder treatments.
For example, over 50 percent of adults with mental illness and 90 percent with substance use disorder did not receive treatment, the White House said, noting that many people with private health coverage struggle to find available mental health providers within their networks.
The proposed new rule aims to give people better access to mental health and substance use disorder benefits by bolstering compliance with the MHPAEA and so forcing health plans to treat them on par with physical health benefits.
What’s in the New Rule?
One way the rule seeks to even the scales of mental and physical health coverage is by requiring health plans to conduct meaningful comparative analyses to ensure that access to mental health and substance use benefits is no more restrictive than access to medical benefits.
The rule also seeks to clarify what health plans can and cannot do. It will provide specific examples to make it clear that health plans cannot use more restrictive prior authorization or other medical management techniques that give priority to medical benefits at the expense of access to mental health and substance use disorder benefits.
A loophole will also be closed under the new rule that exempted certain non-federal governmental health plans, such as those offered to state and local government employees, from complying with the requirements of MHPAEA.
In closing that loophole, the new rule would codify changes made by Congress to MHPAEA by requiring over 200 additional health plans to comply with MHPAEA and provide mental health coverage to an additional 90,000 consumers.
The White House said that the new rule would also help boost pay for mental health care professionals by increasing utilization of mental health and substance use care, also likely creating incentives for more people to join the mental health workforce.
Besides announcing the new rule, the White House said it would also issue a request for information from states on how it can best work with them to ensure compliance with MHPAEA in terms of protections for Medicaid beneficiaries enrolled in private Medicaid plans.
AHIP, a national association health care coverage providers, published a statement on July 24 detailing various actions by dozens of health insurance providers to bolster access to mental health benefits, signaling that insurers are sensitive to the issue.
“As we evaluate these significant new proposals, we want to reiterate and make clear: mental health is good health, period,” Kristine Grow, Senior Vice President of Communications and Public Affairs at AHIP, told The Epoch Times in an emailed statement. “We agree that everyone deserves access to mental health care, and that access should be on par with physical health.”
Access to mental health has been challenging mostly due to a shortage of clinicians, Grow added, noting that health insurance providers have, for years, implemented programs and strategies to expand networks and increase access.
“Health insurance providers have a consistent, clear commitment to improving access to mental health, as well as solutions that will work for Americans,” she said, adding that AHIP encourages the Biden administration to work with health insurance providers, clinicians, patients, and other stakeholders to keep improving access to mental health services.
Focus on Mental Health
The actions announced on Tuesday are the latest in a series of steps the administration has taken in its focus on mental health since President Joe Biden pledged during his 2022 State of the Union address that he would push for “full parity between physical and mental health care.”
Prior steps include proposing rules that would expand access to mental health and substance use care by covering intensive outpatient services and increasing Medicare rates for crisis care, substance use disorder treatment, and psychotherapy.
The Biden administration has also invested nearly $1 billion into bolstering the 9-8-8 suicide and crisis lifeline, including by developing video phone services to provide better services to those who are deaf or hard of hearing.
There has also been a proposed rule that would make it easier for schools to bill Medicaid by streamlining billing permissions and processes.
“Mental health care is health care,” Mr. Biden said in a July 24 tweet.
“That’s why I’m proud to have released a new national strategy to transform how we understand and address mental health in America—training more providers, improving access to care, and building healthy environments that promote mental health.”
*This article has been updated to include comments received from an AHIP spokesperson.
From The Epoch Times
