Aug. 10, 2017
Laurel Fuller
ASPE
200 Independence Ave., SW Room 424E
Washington, DC 20201
Re: Mental Health Parity Comments Following Listening Session
Dear Ms. Fuller:
The Bazelon Center for Mental Health Law submits these written comments for the record following the July 27, 2017 listening session concerning Strategies for Improving Parity for Mental Health and Substance Use Disorder Coverage. The Bazelon Center is a national non- profit legal advocacy organization that promotes equal opportunity for individuals with mental disabilities in all aspects of life, including health care, community living, housing, education, employment, and other areas.
- As part of its parity enforcement efforts, HHS should require insurers to providesufficient information to enable beneficiaries and health care providers to determine whether a plan complies with parity requirements.
It is extremely difficult for consumers, providers, and advocates to obtain information about what services are covered by insurance plans and what quantitative and non-quantitative treatment limitations apply to these covered services. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), mental health service limitations must be compared and contrasted to those limitations placed on medical and surgical services. Insurers do not provide materials that would allow consumers, providers, or advocates to understand this analysis. Due to this lack of transparency, determining when parity violations have occurred is extremely difficult.
We believe it is incumbent on HHS to require that all health plans (including Medicaid managed care plans) provide to consumers, families, health care providers, and regulators:
- A full and complete list of mental health and medical/surgical services that details quantitative and non-quantitative treatment limitations and financial restrictions applied to each service.
- For non-quantitative treatment limitations, such as the application of medical necessity criteria, a full explanation of how these criteria were applied to decisions concerning coverage of mental health or substance use disorder services should be provided.
It is within HHS’s enforcement authority to require plans to provide this information; without it, enforcement of MHPAEA would not be—and has not been—effective. Moreover, since this information must be collected by health plans in order to conduct a parity analysis, it would not be difficult for them to prepare this material for consumers, providers, and advocates.
- HHS, Department of Labor and Department of the Treasury should provide clear, easily accessible guidance to the public concerning how and where to file MHPAEAcomplaints.
Little information is available and easily accessible to individuals seeking to determine where and how to submit complaints if they believe that they may have been subjected to a violation of MHPAEA. Neither the Department of Labor nor the Department of Treasury or the Department of Health and Human Services maintains or directs people to a clear and easily accessible webpage for submitting complaints. It is crucial that these departments create such a page and provide clear information directing individuals to it.
Sincerely,
Jennifer Mathis
Director of Policy and Legal Advocacy
