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House of Representatives
Session of 2019 - 2020 Regular Session

MEMORANDUM

Posted:	March 15, 2019 02:15 PM
From:	Representative Aaron D. Kaufer
To:	All House members
Subject:	Insurance Transparency

Serious alcohol and drug problems afflict 1 in 4 families in all of our legislative districts to devastating effect. The problem destroys families, drives up crime and destabilizes whole neighborhoods. In 2017, 5,456 Pennsylvanians died of overdoses. In the face of this continuing death and destruction, we must continue our work together to help our struggling families and to ensure that individuals and families are able to access treatment for addiction through their health care coverage. The legislation I am proposing will simply assure that purchasers of insurance are able to access coverage for addiction treatment already included in the health plan. In 2008, the Federal Mental Health Parity & Addiction Equity Act was enacted into law. Under its provisions, health policies that include treatment for alcohol and drug addiction and/or treatment for mental illnesses must provide that coverage in parity with other illnesses. Despite this federal law, families and individuals struggling with alcohol and other drug problems are often unable to access that coverage or even to know if their plan is in compliance with the law in the first place. To address this problem and to ensure compliance with the Federal Mental Health Parity & Addiction Equity Act, I am proposing three bills. Let’s make certain that Pennsylvanians can access treatment for addiction and get help for their families.

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Document #1

Description:

The first requires insurers to certify that they are in compliance with the Federal Mental Health Parity & Addiction Equity Act through certification by an officer of the plan.  Currently, certification to the Insurance Department can be made by “an authorized representative” of the plan and the current certification of compliance applies only to policy forms and documents, not to compliance with the actual delivery of services or handling of claims.

Document #2

Description:	The second bill requires health plans to notify subscribers of the addiction treatment coverage available to them in the plan and how to access it.

Document #3

Description:	The third bill provides for standardized reporting by insurers on the provision of alcohol and other drug addiction treatment with copies of the report submitted to the General Assembly and made available to the public.  The reports would include data such as: numbers treated, numbers in each level of care, average lengths of stay, denials and other adverse benefit determinations.