Uncle Sam Beefs Up Mental Health, Addiction Coverage

New federal regulations under the Affordable Health Care Act (ACA) require insurance companies and health care providers to treat mental illness and addiction in the same way as physical ailments. That’s good news for everyone with health insurance.

The ACA prohibits denying coverage or charging higher premiums to due pre-existing conditions, which include mental illness, while expanding coverage for screening and behavioral assessments and eliminating co-payments or out-of-pocket fees.

The rules beef up the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 by closing loopholes and setting implementation guidelines– an advance that Secretary of Health and Human Services (HHS) Kathleen Sebelius calls “the largest expansion of behavioral health coverage in a generation.” Under the regulations, mental health benefits must match those for medical and surgical treatment, including copayments, deductibles, number of visits to providers, residential treatment, and outpatient services.

The regulations could affect 62 million people, including 23 million substance abuse addicts. Administration officials called the new rules a response to the need to help the mentally ill get help before they commit such violent acts as the massacres in Aurora, DO and Newtown, CT.

Cynthia Moreno Tuohy, Executive Director of the National Association of Alcoholism and Drug Abuse Counselors, and American Psychiatric Association President Jeffrey Lieberman praise the rules for providing expanded care.

“Health plans have supported MHPAEA and worked to implement these requirements in a manner that’s affordable, safe and effective,” adds Karen Ignagni, President of America’s Health Insurance Plans, a trade group of health insurance companies. “The new regulations enable patients with mental and behavioral health conditions to keep benefitting from the innovative programs and services that health plans have pioneered.”

To learn more about how these rules will apply to your health insurance, feel free to get in touch with us.