Advocates await final rule on Mental Health Parity Act

With the government shutdown now over, behavioral healthcare advocates are hoping the Obama administration will soon release the long-awaited final rule under the Paul Wellstone and Pete Domenici Mental Health Parity Act that Congress passed five years ago.

Sources say it's a good sign that the Office of Management and Budget is reviewing the regulation, which would make final an interim final rule that was published in February 2010. Included in the Emergency Economic Stabilization Act of 2008, the mental health parity legislation requires group health plans of more than 50 employees that provide both medical-surgical and mental health-substance abuse coverage to make sure that the financial requirements and treatment limitations are equal for those benefits. And the Patient Protection and Affordable Care Act later built on the 2008 parity law when it included mental health and substance abuse parity benefits in the essential health benefits package offered through the health insurance exchanges for small businesses and the individual market.

Mark Covall, president and CEO of the National Association of Psychiatric Health Systems, said his group heard that the Obama administration had planned to release the rule ahead of the Kennedy Forum, an event that former Rep. Patrick Kennedy (D-R.I.) will host this week in Boston to improve healthcare policy for those with mental illness and addictions. But the two-weeklong government shutdown put everything on hold. Kennedy's event, for which NAPHS is a sponsor, is meant to coincide with the 50th anniversary of President John Kennedy's signing of the Community Mental Health Care Act.

Although the OMB is the last stop before a rule is released, Covall acknowledged that it could also take some time. He's confident, though, that the rule will be released by year's end, which would fulfill a promise the president made in the aftermath of the Sandy Hook Elementary School shootings.

“I would expect that they're pretty close in releasing the final rule,” Covall said. “That's a signal that it's sooner rather than later,” he said.

An area of particular interest for mental healthcare advocates is whether the rule will ask for parity in the scope of service that plans cover. Behavioral healthcare advocates want to be sure, for example, that if a health plan offers medical coverage for a hospital stay, rehabilitation services and skilled nursing, the same applies for mental health benefits.

“This was not addressed in the interim final rule,” Covall said. “We think it's a really important issue because the whole parity concept is to create equality across medical and behavioral care,” he said, adding that not accounting for this range of services would provide insurers with a way to restrict access to necessary and proper care.

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