NEW YORK, Sept 9 (Askume) – The Biden administration said on Monday it had finalised rules that will help ensure the 175 million Americans with private health insurance have access to affordable mental health services.
The Mental Health Parity and Addiction Equity Act of 2008 already requires insurance companies and corporate-backed health plans to provide access and payment structures for mental health care services that are similar to those for other medical services.
But in reality, that’s often not the case, with less than half of American adults with mental illness having access to care in 2020, and nearly 70% of children not receiving treatment, according to research cited by the government.
Part of the problem is that mental health care providers are not adequately covered by insurance plans, causing patients to pay out of pocket or forgo care.
“This rule addresses issues of network adequacy and recognizes that low pay for mental health providers is a major contributor to network adequacy,” said Dr. Jared Skillings, director of professional practice for the American Psychological Association.
“Although some insurers may claim that the lack of networks is primarily due to labor shortages, we disagree.”
The final rule proposed last summer aims to require health insurers to evaluate which mental health providers their plans cover, how much those providers are paid, and how often they require or deny prior approval for coverage.
Such requirements could motivate health plans to bring mental health providers into networks when needed, a senior administration official said. Most of the new rules would take effect in 2026.
Patients in private health plans pay an average of $1,500 a year for mental health care, White House domestic policy adviser Neera Tanden said at a press conference.
He said that’s often because they seek coverage from an out-of-network provider.
“For you, finding a health care provider who can treat your eating disorder is as different as finding a health care provider who can treat your ulcer,” said Lisa Gomez, assistant secretary of the U.S. Department of Labor.
The Department of Labor regulates corporate-sponsored health plans under the Employee Retirement Income Security Act of 1974 (ERISA).
The trade committee’s Employee Retirement Income Security Act Industry Committee, which represents large U.S. employer-sponsored health plans, submitted comments to the Labor Department in October arguing that the rule would result in additional costs for employer-sponsored health plans and increase health care fee enrollment. . WHO.
The committee said in a statement Monday that the potential impact of the change is concerning and far exceeds the goals set by Congress in its legislation.
“We will consider all ways to protect employers that offer behavioral health benefits and the employees and families who rely on them,” Melissa Bartlett, the commission’s senior vice president for health policy, said in a statement.
