The House and Senate managed to reach an agreement on a mental health parity bill and to see it become law before adjourning. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, H.R. 6983, was signed into law on October 3 as part of the $700 billion bailout package. The passage of this legislation marks the culmination of over a decade-long struggle by mental health advocates to gain greater equity in the provision of mental health and substance use disorders services under group health plans. The compromise bill was introduced in the House on September 22 by Representatives Patrick Kennedy (D-RI) and Jim Ramstad (R-MN), two long-standing advocates on mental health.
Several months earlier, the House and Senate each passed mental health parity bills. However, differences between the two bills and Congressional Members’ inability to reconcile these differences kept the issue from moving forward. (For details on the differences see HNR article, October 1, 2007) The impasse was resolved when the House agreed to drop its provision requiring coverage for any condition listed in the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders”. Instead, GAO studies will be conducted to analyze trends in coverage and to make sure certain conditions are not excluded. The Senate agreed to language stating that if a plan already offers out-of-network benefits for medical/surgical care, then it must also provide similar benefits for mental health services.

In addition to these provisions the new law requires that insurers that choose to offer mental health services have equivalent treatment limits and financial requirements for these services as for medical/surgical care. State parity laws providing stronger consumer protections, benefits and rights will be preserved. Businesses with less than 50 employees are exempted. The effective date for most health plans will be January 1, 2010. It is estimated that the newly instituted law will improve coverage for 113 million people.

Subscribe: