The regulations would require health insurance companies to collect and report more data on how they limit and deny mental health claims, something ProPublica has reported as a way of regularly mistreating patients who seek treatment.
by Maya Miller and Annie Waldman, ProPublica
The Biden administration said Monday New Regulations Strengthen protections for mental health care coverage and hold insurance companies accountable when they wrongfully deny coverage.
The rule updates the Mental Health Parity Act and Addiction Parity Act passed in 2008, requiring health insurance plans to offer the following: Equal access to mental health care As for medical care, new provisions will require health insurance plans to collect and report more robust data on how they limit or deny mental health claims. If there are disparities between mental health care and medical care, insurers will have to explain how they intend to address these gaps.
“Mental health care is health care. But for too many Americans, critical care and treatment are out of reach,” President Joe Biden said in a press release announcing the final rule. “There’s no reason to treat a broken arm and a mental illness separately.”
The revised rules include many the study and Reports And a recent ProPublica investigation looked into it with a new level of detail.
Although nearly all Americans have health insurance, millions still lack access to mental health care. ProPublica finds insurance companies interfering with patient careconducted aggressive audits and set reimbursement rates so low that providers felt forced to leave their insurance networks. In our report, How deadly the consequences could be When patients can’t access therapists or mental health treatment.
Federal regulators Had a hard time cracking down on insurance companiesNearly all of the recent reports the Labor Department collected from insurers and health insurance associations lacked enough detail to determine whether the companies were complying with the law. The ministry reported to Parliament Last year, some states enacted legislation to fill information gapsHowever, we found that mental health protections often vary depending on where you live.
The new rules require insurers to collect and submit outcome data, such as denial rates, to measure how often patients receive care. Insurers will have to disclose details of their insurance networks, which could include how often patients go outside their networks for mental health treatment and how they calculate reimbursement rates for mental health providers.
The rules also make clear that patients have the right to access this data, and insurers and health insurance associations must hand over the records within 30 days. request.
Rep. Virginia Foxx, a Republican from North Carolina who chairs the Committee on Education and Labor, called the rule too burdensome. “Far from improving access to mental health care, this rule puts paperwork ahead of patients,” Foxx said in an emailed statement.
But former U.S. Rep. Patrick J. Kennedy, sponsor of the 2008 Equality Act and co-founder of the mental health advocacy nonprofit Kennedy Forum, said the new rules would protect patient access. “This is an opportunity for consumers to finally have a say in the discussion,” he told ProPublica.
The law applies to 175 million people who have private health insurance. The new rules also extend these protections to people who get health insurance through their state or local governments — about 120,000 Americans.
The final rule was developed after a year-long review process involving the Treasury Department, the Department of Health and Human Services, and the Department of Labor, which collected thousands of public comments. Published Proposed Rules Lisa Gomez, undersecretary for Employee Benefits Security at the Department of Labor, said some of the provisions will take effect Jan. 1.
“People living with mental illness and substance use disorders continue to face greater barriers,” she said. “This is unfair, it’s wrong and it’s illegal.”
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