Department of Labor Takes Stand in Support of Mental Health Parity

It is challenging enough to deal with a mental health condition; it can be even more frustrating to be denied coverage for treatment. Imagine the heartbreak when one family in Texas filed an appeal and ultimately a lawsuit to obtain coverage, only to have the judge throw out their suit stating that the Mental Health Parity and Addictions Equity Act (MHPAEA) did not apply.

The parity law requires health plans to cover mental health benefits on the same terms that they cover medical and surgical benefits. The plaintiff in this case argued that these “[e]xclusions are a proxy for disability discrimination, and improperly exclude coverage of medically necessary services to enrollees with developmental mental health conditions.”

Now imagine their delight when the Department of Labor (DOL) came to their side and filed an amicus brief. The DOL wants the U.S. Court of Appeals to revive the lawsuit. The crux of the issue is around the plaintiff’s invoking the Employee Retirement Income Security Act (ERISA). In June, a district judge blocked a family from using ERISA to challenge a parity violation. But, DOL says that was wrong. In DOL’s brief filed with the First Circuit, it stated health plan participants can bring ERISA benefit claims to challenge coverage denials that violate federal mental health parity law.

“[C]ourts must disregard any plan terms that violate ERISA’s requirements, a beneficiary…seeking ‘to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan,’” the department says, quoting the ERISA statute.

This is a major step forward in the fight for enforcement of the parity law. This brief signals DOL, which is responsible for enforcement, is paying attention and is willing to enter into matters of lawsuits in addition to departmental violation complaints.

View DBSA Discussion Around the Value of Shared Decision Making and Peer Support

Earlier this month DBSA participated in a live interactive discussion that explored how peers can better work with their clinicians in identifying treatment options centered around their preferred outcomes. Referred to as “shared decision-making,” this collaborative process between the peer and their health care team has been proven to achieve better peer-centric results.

The 60-minute, interactive program called “The Peer Perspective of Challenges, Purpose, and Hope with Continuing Depression” included program panelist Maria Margaglione, DBSA Programs Director who informed participants on DBSA wellness resources that can assist peers in preparing for visits with their clinicians. Two DBSA peer advocates also shared their own perspectives.

Joining DBSA were panelists Dr. Larry Culpepper, Professor of Family Medicine at Boston University School of Medicine and Dr. Michael Thase, Professor of Psychiatry at the Perelman School of Medicine, University of Pennsylvania.

In addition to discussing how to optimize shared decision-making, the panelists reviewed what to do when symptoms persist despite following treatment recommendations, and how to weigh treatment risks and benefits with your health care team.

Peers were able to submit questions which were answered by the panelists. We invite you to view the program at this link.

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