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Psychiatrists, Psychologists and Mental Health Counselors Take Note: Insurers are Trying to Delay Mental Health Parity! The Whole Managed Care Industry is in Danger and Trying to Fighting Back.

A group of managed care organizations, cynically called the Coalition for Parity Inc., has filed suit in U.S. District Court to delay the implementation of the federal mental health parity bill.   The Coalition claims its members were not given enough time to comment on the parity rules before they became final.

The Mental Health Parity law, simply put, prohibits health insurers from placing special limits on mental health coverage that don’t exist for other medical specialties.  We can absolutely understand why this would be supremely threatening to a certain industry called the behavioral health managed care industry.  The only reason behavioral health companies [i.e. “managed care companies”], or mental health “carve-outs” exist is to place special limits on mental health care.  This is what they are selling to the companies that pay them – mostly big insurance companies, but also some large self-employed insurers.

There are various mechanisms that managed care companies use to achieve their goal of limiting access to mental health care.  Some of the more effective measures are larger deductibles for mental health, limiting the number of visits to a psychiatrist or other mental health professional, and requiring psychiatrists, psychologist and psychotherapists to obtain pre-approval of all mental health services before an insurer will agree to pay for them.  All of these techniques work well in (1) limiting the availability of mental health services to people in need and (2) avoiding having to pay for mental health services that somehow do get delivered.

Well, America’s big insurers don’t do any of this stuff for other medical specialties!  It’s anti-parity by definition.   If mental health parity is to have any meaning, carve-outs will have to stop applying these limiting  activities to mental health, and there will be no further reason for mental health carve-outs to exist.   Ouch! - at least if you’re in the mental health carve-out business!

A whole big-money industry like this is unlikely to go down without a fight, so we should expect the mental health carve-out companies to close ranks and do what they can to delay and avoid implementation of the mental health parity bill.  It’s be our job to demand that this bill, which is extremely good for America’s mental health care consumers, be implemented as written and intended by Congress.


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