We are asking for your help to make compliance with the federal parity law a reality.
Although the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted over four years ago, the final federal rule implementing the law has not been issued. Although it has promised a final MHPAEA rule by the end of the year, the Obama Administration has not clarified if the necessary protections will be in the final rule. The Administration needs to hear from social workers who have witnessed parity violations, so that these practices are clearly prohibited in the final rule. Parity violations include insurance plans denying or more strictly managing mental health and addiction treatment services than other services covered by the plan. Some specific examples include:
- Mental health outpatient sessions that are limited by utilization review (also known as medical necessity review), which is not conducted for medical and surgical conditions.
- Insurance companies that do not cover residential treatment or intensive outpatient care.
- Insurance companies that refuse to explain why they have denied mental health or addiction treatment.
- Provider reimbursement rates that are too low, requiring providers to offer services out-of-network. This results in consumers paying higher out-of-pocket costs.
More information can be found at www.parityispersonal.org. The NASW Legal Defense Fund has also published a parity article, which summarizes the pertinent provisions of the interim final rule: https://www.socialworkers.org/ldf/legal_issue/2010/201004.asp
Your Requested Action:
E-mail your parity violation story to both the Departments of Labor and Health and Human Services. We encourage stories to be reported by either consumers or social workers who are dealing with the parity issue. Be sure to tell your personal story and attach any relevant documents (if available) such as a denial letter, summary of benefits or other materials provided by the health plan. Please be mindful about safeguarding client confidentiality and refrain from including identifying information in your correspondence to DOL and DHHS.
Send your e-mail to:
You can, in addition to your E-mail, place your complaint over the phone by calling the Department of Labor at 866-444-3272 or the Department of Health and Human Services’ Center for Insurance Information and Oversight at 877-267-2323; ext 61565. Be sure to obtain a tracking number for your complaint, to be sure it is actually registered in their system. Be sure to also send a copy of your message to firstname.lastname@example.org.