QUINN: Blasts Kyl Medicare Bill, Mental Health Parity Act
Syndicated columnist Jane Bryant Quinn this weekend devoted columns to a Medicare physician contracting bill proposed by Sen. Jon Kyl (R-AZ) and Rep. Bill Archer (R-TX), and to the federal Mental Health Parity Act, which took effect his month. The Kyl bill (S 1194 and HR 2497) would "restore seniors' constitutional right to privately contract" with physicians for services not covered under Medicare, according to the United Seniors' Association (USA), which has lobbied heavily for the bill. The USA claims that the right to contract privately expired this year. Quinn disputes this fact, and comments that the bill would provide doctors with opportunity to apply subtle pressure upon seniors to cover some expenses themselves, rather than submitting all treatment costs to Medicare for reimbursement. Quinn expresses concern that physicians would use private billing contracts with seniors as an opportunity to charge a premium for some services, such as X-rays, medical tests or specialty treatments -- even phone calls and office paperwork. Quinn says the bill is not in seniors' best interest, but rather "for doctors who want to escape from Medicare's cost controls." Current federal law prevents doctors from charging more than 15% above Medicare-approved levels for any Medicare-covered service. The bill's backers "say that seniors are too savvy to agree to pay more than the Medicare limit," but, Quinn asks, "will all seniors know that contracts with doctors don't have to be signed? Especially if your doctor says that his or her costs have gone up and this is the office's new rule?" Proponents imply that unless the Kyl bill passes, Medicare patients will be barred from signing any type of supplementary physician contract and therefore will be prevented from obtaining any service or treatment not covered under Medicare. In reality, patients are free to pay privately for any service, Quinn writes (Ventura County Star, 3/1).
"For deceptive titles, nothing beats the federal Mental Health Parity Act," Quinn writes. While the law claims to equalize coverage for mental and physical ailments, Quinn says "there's still no true parity in the law, as anyone with mental illness in the family will soon find out." While the law requires that health plans of companies with more than 50 employees "set the same maximum dollar payment for all covered diseases," it fails to require minimum levels of coverage. Further, as employers are not required to offer mental health benefits at all, many may respond to the act by eliminating all mental health benefits or making it more difficult to qualify. Quinn lists a number of ways companies can discourage employees from using benefits, such as limiting the number of treatment sessions or raising copayments. Further, she writes, companies "don't even have to offer equal lifetime dollar caps if that raises their health insurance costs by 1% or more." Some state-regulated group health plans, including those of Colorado, Connecticut, Maryland, New Hampshire, Rhode Island and Vermont, are required to "cover severe mental illness on a truly equal basis with physical illness." But while some proponents, such as the National Alliance for the Mentally Ill, claim the federal "law is at least a moral victory," Quinn argues the mental health parity law has some distance to travel before it lives up to its name (New York Daily News, 3/1).