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10/18/2019 03:23 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20190&cosponId=29730
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House of Representatives
Session of 2019 - 2020 Regular Session

MEMORANDUM

Posted: June 4, 2019 09:19 AM
From: Representative Thomas P. Murt
To: All House members
Subject: Mental Health Parity and Addiction Equity
 
“Our country must make a commitment: Americans with mental illness or addictions deserve our understanding, and they deserve excellent care. They deserve a health care system that treats their illness with the same urgency as a physical illness.”
. . . . President George W. Bush

In 1996, President George W. Bush signed the Mental Health Parity and Addiction Equity Act into law. Essentially, this federal law is a step towards requiring that most insurance carriers, cover mental illness and addictions in the same magnitude as they do a physical illness. While this law was a step in the right direction, enforcement of the law has not always resulted in true parity and equivalence of care.

Enforcement of this important law is the responsibility of our own Department of Insurance. They do this by responding to complaints filed to their operation regarding parity. Sadly, many people who need mental health or addictions health care, are often incapable of complaining because they are actively in crisis. Filing a complaint and/or fighting through due process, with the insurance company in question, is not always realistic when a loved one is the midst of an addiction or a mental health crisis.

In addition to the complaint process, another method utilized by our own Department of Insurance to assess compliance is through a complex, byzantine, and complicated auditing procedure called a market conduct audit. This process literally takes months to do for one single carrier. The Department of Insurance hires outside firms and vendors to assist them.

I will soon introduce legislation that insurance carriers in the Commonwealth that cover behavioral health, be required to submit certain information each year to our Department of Insurance, that helps the department to ascertain if the insurance carrier is being compliant with the federal Mental Health Parity and Addiction Equity Act. This same information is currently gleaned through months-long market conduct audits of insurance records.

Note: This bill will NOT require insurance companies to cover any condition or illness that they do not already cover. There is no mandate nor extension of status quo coverage. We are simply asking our insurance carriers to submit the needed data so our own Department of Insurance can efficiently and cost-effectively perform their market conduct audits to assure compliance with the Mental Health Parity and Addiction Equity Act. In addition, this bill has been drafted with the cooperation and input of our own Department of Insurance. Their needs to accurately assess compliance with the Mental Health Parity and Addiction Equity Act were primary factors in drafting this bill. In closing, research has repeatedly manifested that treating an underlying behavioral health illness has long-term cost benefits to the insurer by reducing the cost of treating acute and chronic physical illnesses by half or more.”

Please co-sponsor this important legislation.



Introduced as HB1696