Stakeholders Say CMS’ Mental Health Parity Proposal Is Inadequate
Stakeholders say CMS' proposed rule that would extend mental health and substance use disorder treatment parity requirements to the Children's Health Insurance Program, Medicaid alternative benefit plans and Medicaid managed care plans would help beneficiaries but access-to-care issues still would remain, Modern Healthcare reports (Dickson, Modern Healthcare, 4/7).
The proposed rule, issued Monday for the 2008 Mental Health Parity and Addiction Equity Act, would require the plans to cover treatment for mental health issues and substance use disorders in the same way they do physical illnesses. Such requirements have applied to insurers and group health plans under final rules released in 2013.
The new proposed rule would affect about 850,000 CHIP beneficiaries and about 21.6 million Medicaid beneficiaries. Thirty-seven states and Washington, D.C., currently contract with managed care plans to provide benefits to at least a portion of their CHIP or Medicaid beneficiaries. About 70% of Medicare beneficiaries are in managed care plans. The proposed rule also would require CHIP, Medicaid alternative benefit plans and Medicaid managed care plans to inform beneficiaries of the reason for any denial of payment for substance use disorder or mental health treatment.
The proposed rule would not apply to fee-for-service Medicaid plans (California Healthline, 4/7). However, CMS in the proposed rule said it hoped the policy would prompt states to enact similar parity requirements in their Medicaid programs.
Tara Bishop -- an assistant professor in the department of public health and medicine at Weill Cornell Medical College, said -- "One of the questions that still remains in terms of access to care is whether there is the workforce to care for these people, particularly psychiatrists." She added that psychiatrists "are the least willing to take any type of insurance, including Medicaid" among all medical specialties.
Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors, said he did not think the proposed rule would "lead to much of a change" for private providers.
Meanwhile, Shirley Ann Higuchi, the American Psychological Association's associate executive director of legal and regulatory affairs, said APA's "membership is very interested in participating in Medicaid." She said APA had worked with providers to develop financially viable strategies to treat Medicaid beneficiaries, even though she said Medicaid has low payment rates for psychiatric services (Dickson, Modern Healthcare, 4/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.