WASHINGTON-U.S. Senators Chris Murphy (D-Conn.), member of the U.S. Senate Committee on Health, Education, Labor, and Pensions, and Richard Blumenthal (D-Conn.) joined 12 of their Senate colleagues to reintroduce the Behavioral Health Coverage Transparency Actlegislation that would strengthen monitoring and enforcement of federal parity laws.
“Insurance companies often put up bureaucratic hurdles that making it nearly impossible for patients to access mental health care. It’s against the law, and that’s why I’ve long lobbied for tougher enforcement of our federal parity laws. This legislation would take important steps to ensure that insurers who use red tape to deny coverage are held accountable and that patients are well informed of their right to mental health care. I continue to push for further improvements to make parity a reality,” Murphy said.
“While mental health parity has been the law for many years, families in Connecticut have continually been denied benefits for essential health diagnostic and treatment services. This vital legislation will help remove one of the greatest barriers to accessing mental and behavioral health care – insurer refusal to cover the cost of such care – through much-needed transparency and accountability.” said Blumenthal.
This Congress, the legislation was updated to reflect improvements passed in the Consolidated Appropriations Act of 2021 (CAA), which was led by Murphy. The CAA has granted the Departments of Health and Human Services (HHS), Labor (DOL), and Treasury increased oversight powers to help provide new information about insurance company compliance with federal health and safety laws. parity.
In February this year, departments released their first report following the implementation of these new provisions and documented significant compliance gaps, confirming that much more needs to be done to strengthen enforcement. of the law and protect consumers.
The updated legislation, which builds on the provisions adopted in the CAA, would:
- Increase transparency by requiring insurance schemes and third-party administrators to submit annual reports containing information on any non-quantitative processing limitations and disclose additional data on denial rates, reimbursement rates and network adequacy ;
- Encourage compliance by ensuring HHS, DOL, and Treasury conduct a review of at least 100 plans per year, including 40 random audits;
- Establish a toll-free phone number and online consumer parity portal to provide patients and providers with a centralized website hosting information about patient rights, results of monitoring efforts, and resources to ensure that health care consumers receive the protections guaranteed to them by law; and
- Support consumers by encouraging collaboration among federal agencies and with states, including providing grants to establish, expand, or provide support to health insurance consumer assistance offices and health insurance mediation programs .
This legislation is also co-sponsored by U.S. Senators Warren (D-Mass.), Baldwin (D-Wis.), Booker (DN.J.), Brown (D-Ohio), Kaine (D-Va.), Klobuchar ( D-Minn.), Luján (DN.M.), Markey (D-Mass.), Sanders (I-Vt.), Smith (D-Minn.), Stabenow (D-Mich.) and Van Hollen (D -Md.). Last year Murphy introduced the Parity Implementation Assistance Act with U.S. Sen. Bill Cassidy, MD, (R-La.) That would spur greater compliance with federal mental health parity laws. The bipartisan legislation builds on the Murphy-Cassidy Mental Health Parity Compliance Act of 2019, which became law in 2020 and provided federal and state health insurance regulators with additional tools to monitor and ensure compliance with mental health parity laws.
It has received support from more than 50 advocacy organizations and experts, including:
The American Psychiatric Association, Community Catalyst, National Alliance on Mental Illness, The Kennedy Forum, Legal Action Center, 2020 Mom, American Academy of Addiction Psychiatry, American Academy of Social Work and Social Welfare, American Association for Psychoanalysis in Clinical Social Work, American Health and Disability Association, American Foundation for Suicide Prevention, American Group Psychotherapy Association, American Occupational Therapy Association, American Psychoanalytic Association, American Psychological Association, American Society of Addiction Medicine, Anxiety & Depression Association of America, Association for Ambulatory Behavioral Healthcare, Bazelon Center for Mental Health Law, Campaign for Trauma Informed Policy and Practice, Children and Adults with Attention-Defict Hyperactivity Disorder (CHADD), Clinical Social Work Association, College of Psychiatrists and Neurologic Pharmacists, Depression and Bipolar Support Alliance, Eating Disor der Coalition, Global Alliance for Behavioral Health and Social Justice, Jewish Federations of North America, Inseparable, International OCD Foundation, International Society for Psychiatric Mental Health Nurses, Lakeshore Foundation, Maternal Mental Health Leadership Alliance, Mental Health America, NAADAC, the Association for Addiction Professionals, National Alliance to Advance Adolescent Health, National Association for Behavioral Healthcare, National Association for Children’s Behavioral Health, National Association of Addiction Treatment Providers, National Association of Pediatric Nurse Practitioners, National Association of Social Workers, National Association of State Mental Health Program Directors, National Eating Disorders Association, National Federation of Families, National Health Care for the Homeless Council, National League for Nursing, NHMH – No Health without Mental Health, Partnership to End Addiction, REDC Consortium, RI International, School Social Work, Associ ation of America and SMART Recovery.
“The Behavioral Health Coverage Transparency Act builds on the 2020 amendments to the Parity Act and requires greater accountability from health plans and insurers. The January report to Congress from federal agencies responsible for parity enforcement found that significant work remains to be done to fully comply with the law. We commend Senator Warren and Representatives Porter and Cárdenas for their continued focus on implementing mental health parity. » — Saul Levin, CEO and Medical Director of the American Psychiatric Association, MPA
“The Behavioral Health Coverage Transparency Act addresses two key strategies to deliver on the promise of the Parity Act: helping consumers understand and enforce their right to fair coverage for substance use disorders and mental health, and improving federal oversight of health plan parity compliance. Providing new federal funds to states to establish independent consumer assistance offices will ensure that individuals and families who encounter barriers to insurance have the practical support they need to overcome them. Coupled with stronger federal enforcement of carrier compliance requirements and greater transparency, this bill will help address the growing mental health needs and growing overdose crisis in communities across our country. » — Ellen Weber, Senior Vice President for Health Initiatives, Center for Legal Action
“Discriminatory practices by health insurers prevent people from getting the life-saving care they need for substance use disorders and mental illness. By holding health plans accountable for providing equitable coverage, the Behavioral Health Coverage Transparency Act will increase access and promote health equity so that everyone receives the care they need, when he needs it! — Emily Stewart, Executive Director, Community Catalyst
“Despite the passage of Mental Health Parity and Addiction Equity Act 14 years ago, we still too often saw health insurers failing to provide coverage for mental health and addictions services at par with physical health care,” said Hannah Wesolowski, advocacy manager for NAMI, the National Alliance on Mental Illness. “The strong oversight provisions of the Behavioral Health Coverage Transparency Act will help us move towards equity in mental health care. We thank Senator Warren and Representatives Porter and Cárdenas for continuing the fight for parity so that people can receive mental health care when they need it.
“The Parity Act has gone unenforced for years as Americans die from substance use disorders and mental health issues. We are pleased to support the Health Coverage Transparency Act behaviour, which will contribute to the application of this essential law.” — Mark Dunn, Director of Public Policy, National Association of Addiction Treatment Providers