Physician Patient

Archive for March 17th, 2019

Conundrum: Regulating the fox in the hen house of mental health parity

Sunday, March 17th, 2019

As  emphasized in the March 17 Star Tribune editorial, the real priority for achieving “mental health parity” should be to help “struggling families,” rather than enfranchising the [health care] industry. We have ample proof that insurance company payment criteria for mental and substance use disorders cover short-term and crisis-focused mental health conditions and disregard the value to patients and families of continuity of professional relationships, as well as allowing adequate payment for non-acute, complex, chronic, care (including children and adolescents). 

The (bipartisan) federal Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act of 2008 (signed by President Bush) enfranchised insurers to decide on claims of “medical necessity.” Thus, an unintended consequence of (well intentioned) mental health parity legislation is industry justification for denial of third party payments for mental health care.

Why not encourage the patient’s insurance company to pay mental health insurance benefits directly to the enrollee (patient or family)? Then, regulators can monitor and compare real money spent on “physical” and “mental” conditions, and consumers can choose licensed “providers” who are responsive to their needs?

References:

http://www.startribune.com/help-those-with-mental-health-issues-by-passing-parity-bill/507227482/

Minnesota Legislation

https://www.globenewswire.com/news-release/2019/03/05/1748331/0/en/U-S-Federal-Court-Finds-UnitedHealthcare-Affiliate-Illegally-Denied-Mental-Health-and-Substance-Use-Coverage-in-Nationwide-Class-Action.html

Lee Beecher, MD
President, Minnesota Physician-Patient Alliance