Celebrating 20 Years on the Road Toward Mental Health Insurance Equity
Reaching equity among insurance coverage between physical and mental health requires the participation of all three branches of government. As we celebrate the 20th anniversary of the first mental health parity law in Massachusetts, it is important to acknowledge the role of legislation, the state executive and regulatory agencies, and the attorney general’s office in making mental health parity a reality. This parallel work supports a uniform understanding of the federal law. The result is a clear and consistent application of the federal law and state guidelines so that everyone, including peers, providers, and insurers, understand their rights and responsibilities under the law, free of competing interpretations.
A new bill approved unanimously by the Massachusetts Senate keeps the state moving in the right direction. Under this bill, individuals with mental health issues will have access to health care on par with physical ailments. The bill will remove one barrier to accessing prompt mental health care by eliminating prior authorization requirements for patients experiencing an acute mental health crisis. It would provide the state with better tools to enforce mental health parity laws and create a special commission tasked with recommending a common set of criteria to be used by providers and insurers. One state senator said he struggled with anxiety and depression growing up: “I’m a pretty savvy consumer. If I can’t figure out how to navigate through these barriers in accessing care in this broken system, imagine how many other people in Massachusetts can’t get the mental health they need?”
On the heels of this legislation was a settlement reached by the Massachusetts State Attorney General’s office with seven companies, including five health insurers, that will improve access to mental health care. The basis for some of this litigation is the fact that behavioral health providers in Massachusetts are paid 60% less than primary care physicians, creating barriers to participating in health insurance networks. The result is many patients either pay out-of-pocket or forego treatment altogether. Three of the companies agreed to change reimbursement rates as well as more closely match prior authorization policies for mental health to those of physical health. Another driving litigation factor was that nearly half of provider directories for Medicare Advantage plans have missing or inaccurate information. As part of the settlement, insurers have agreed to improve subscribers’ directory information. Now, patients will be able to more easily identify in-network providers.
Combined, the seven companies agreed to a $1 million settlement that will fund initiatives designed to increase access to behavioral health care services. Speaking about the settlement, the Attorney General’s office said, “People shouldn’t have to jump through hoops in order to get coverage for mental health care. They shouldn’t have to be forced to go out-of-network or pay out-of-pocket because of disparity in the way we treat behavioral health and the way we treat physical health.”
Your voice can make a difference
DBSA is currently advocating for state and national policies around access to mental health services. As a DBSA advocate, you play an important role in communicating with your state and federal legislators about the important needs in your community. Stay tuned for targeted communications to let them know how your family and others are being impacted and call on them to ensure that access to mental health coverage is seen as a right and not a privilege.
We’ve Made Federal Advocacy Easier. Join us from Home for Hill Day
The COVID-19 pandemic has resulted in one of the most challenging environments for supporting our mental health, and the pandemic is exacerbating existing behavioral health issues. Innovative uses of technology in the provision of healthcare, such as telehealth, is increasing to keep people safe in their homes while maintaining access to the care they need.
DBSA has been pushing for expanded access to telehealth for years. Most recently, we expressed support for S.3792, the Tele-Mental Health Improvement Act of 2020, that would require health insurers to cover mental health and substance use disorder telehealth services during the COVID-19 public health emergency. This bill temporarily requires health insurers to cover mental health through telehealth at the same rate as in-person delivery of care. It also specifies that there cannot be barriers to care, such as additional prior authorization requirements, that the patient have a pre-existing relationship with the provider, or that a provider be present when the person receives treatment. This bill will help mitigate some of the pandemic-related increases in deaths of despair due to suicides and overdoses.
DBSA has worked with several coalitions, urging the federal government to implement broader telehealth practices, and now it’s your turn to get involved by joining your peers at the National Council Hill Day. It is easier than ever this year to join with hundreds of mental health advocates with one voice by participating in the National Council’s Hill Day at Home scheduled for the Tuesday, June 23, and Wednesday, June 24.
Be sure to tune into the advocacy discussions on June 23. Our own Advocacy Vice President, Phyllis Foxworth, will join a panel discussion on telehealth at 2:30pm EDT (11:30am PDT). For her part in the discussion, she will focus on DBSA’s success in delivering community-based peer support services via phone and video conferencing and share results of the DBSA survey on how peers feel about participating in telehealth.
Your voice can make a difference
DBSA advocates have been enthusiastic participants in the National Council’s Hill Day since 2011. Last year, DBSA advocates from 17 states participated. Many more DBSA participants now have the opportunity to engage because the event is virtual this year. For more information and to register, click here. Be sure to indicate your involvement with DBSA when you register.