Posts Tagged Case Management
Barack Obama spent much of his first year in office on a quest for health care reform. Those against it alleged a government takeover and those in favor were concerned it didn’t go far enough. Either way you look at it, The Patient Protection and Affordable Care Act was signed into law. What seemed to fall through the cracks of the debate, is the idea of mental health parity – the massive reform in mental health laws that was ultimately attached to the 2008 financial bailout. As a background, The Mental Health Parity and Addiction Equity Act of 2008 says that ALL psychological conditions must be treated the same as any physical illness. Prior to Parity it was common practice to limit patients to a few therapy visits a year, assign higher deductibles or reimburse a small percentage. Under Parity, seperate deductibles can’t apply nor can your out-of-pocket contributions differ.
Although this was a major victory, its taken a backseat to the healthcare reform and the economic stimulus package. The act, which self-funded organizations of 50 or more were required to comply as of Oct 1 2009 or any renewal date following, officially went into effect on January 1, 2010.
So how does this all fit into Health Care Reform? First, Mental Health Parity and its regulations are still in full effect. Second, Health Care Reform has expanded the reach of Parity. It’s now expanded to cover dependents until the age of 26. It has also expanded to fall under the section of “essential health benefit” which means treatment can’t be denied for pre-existing conditions. This means that insurance companies are required to provide coverage and that coverage must be equal to coverage provided for any other medical ailment. Behavioral Health benefits are now a mandatory part of basic care as well as certain psychotropic medications which are required under insurance formularies.
At MINES, while we’ve been working to help groups become compliant with Parity and gain an understanding of how Health Care Reform is impacting Parity and behavioral health overall, we’ve also been helping to put some measures in place to contain the potential cost increases of these massive reforms.
If your organization is in need of some consulting around this topic or any other behavioral health topic we urge you to contact us. We’d also be glad to show you some easy ways to contain costs under the new health care regulations.
Posted by Ian Holtz
Manager, Business Development