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National Behavioral Health Parity Regulations: An Overview and Analysis

This discussion from September 10, 2009, led by Pamela Greenberg, MPP President & CEO of ABHW, and Henry Harbin, MD Consultant, delves into the regulatory aspects of national healthcare reform surrounding behavioral health parity. Find out key areas needing clarification, congressional committee involvement, legislative status, and crucial behavioral health issues on the agenda.

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National Behavioral Health Parity Regulations: An Overview and Analysis

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  1. National Parity Discussion National Behavioral Consortium September 10, 2009 Pamela Greenberg, MPP President & CEO, ABHW Henry Harbin, MD Consultant

  2. REGULATIONS • Departments of Labor, Health and Human Services and Treasury to Issue Regulations 1 Year After the Date of Enactment • RFI released April 28th • Comments were due May 28th • Agencies Received 404 Comment Letters • Interim Final Regulation

  3. Areas That Need Clarification • Are Separate but Equal Deductibles Permitted • Define No More Restrictive than the Predominant Financial/Treatment Limitations Applied to Substantially All Medical and Surgical Benefits • Which State Laws are Preempted • Does the Law Apply to EAPs

  4. Additional Regulatory Comments • Does Parity Apply to: • Management of the Benefit • Fee Schedules • Network Requirements • Are Plans Required to Cover all Evidence Based Treatments/Scope of Services • Can the Plan exclude Certain Types of Providers

  5. National Health Care Reform National Behavioral Consortium September 10, 2009 Pamela Greenberg, MPP President & CEO

  6. Congressional Committees Involved • Senate • Health, Education, Labor & Pensions • Finance • House • Education & Labor • Energy & Commerce • Ways & Means

  7. Behavioral Health Involvement • Whole Health Campaign • SAMHSA • Whole Health Coalition

  8. Status of Legislation • Senate • Affordable Health Choice Act • Finance Committee Policy Options • House Tri-Committee • America’s Affordable Health Choices Act of 2009 (HR 3200)

  9. Some Key General Areas of Interest • Public Option • Employer Requirements • Expansion of Public Programs • Financing • Guaranteed Issue

  10. Some Key Behavioral Health Areas of Interest • Basic Benefits Package/Parity • Prevention & Wellness • SAMHSA • Treatment of Pre-existing Conditions • Adequacy of Provider Networks • Workforce Issues • Medicare – 190 Day Limit

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