AHIP, an advocacy group for insurers, believes that the psychological well being parity rule proposed in July has a number of “flaws” and shouldn’t be finalized, it wrote in a Tuesday remark letter to the Departments of Well being and Human Companies, Treasury and Labor.
The proposed rule builds on the Psychological Well being Parity and Habit Fairness Act (MHPAEA), which went into impact in 2008. It requires well being plans to cowl psychological well being advantages on the similar degree as bodily well being advantages. The proposed rule would mandate insurers to analyze the outcomes of their protection insurance policies, akin to how a lot out-of-network suppliers are paid and the frequency of prior authorization denials.
AHIP famous that it agrees that “protection of psychological well being and substance use dysfunction care have to be on par with medical and surgical care.” Nevertheless, the proposed rule wouldn’t enhance entry to psychological well being care, the group argued within the letter. AHIP laid out a number of suggestions for the federal authorities regarding the proposed rule, together with withdrawing the proposed rule altogether and restarting the method by partaking with stakeholders.
“The proposed rules have vital authorized, coverage, and operational flaws and shouldn’t be finalized. Maybe extra importantly, the proposed guidelines is not going to obtain the objectives of accelerating entry to psychological well being care or substance use dysfunction remedy,” AHIP mentioned. “As an alternative, we urge the Departments to take this chance to assemble stakeholder suggestions concerning the areas that stay unclear for attaining efficient compliance with MHPAEA and use that suggestions to tell a future [notice of proposed rulemaking] that adheres to statutory authority whereas avoiding the unintended consequence of hindering the provision, affordability, or security of psychological well being care and substance use dysfunction remedy.”
Blue Cross Blue Protect Affiliation additionally got here out towards the psychological well being parity rule, arguing that it “might push us within the improper path by forcing well being plans to take away essential protections that guarantee sufferers are receiving secure, medically essential, efficient care,” mentioned David Merritt, BCBSA’s senior vp of coverage and advocacy, in a press release.
BCBSA additionally made a number of suggestions, together with increasing entry to telemental well being providers and permitting behavioral well being suppliers to observe throughout state strains.
Whereas many insurers are towards the proposed rule, different organizations are in favor of it. The American Medical Affiliation got here out in assist of the rule when it was first introduced.
“The American Medical Affiliation strongly helps the Biden administration’s dedication to addressing insurers’ continued failures to adjust to the Psychological Well being Parity and Habit Fairness Act (MHPAEA),” mentioned Dr. Jesse Ehrenfeld, president of the AMA, in a assertion. “For greater than 15 years, the mixed lack of enforcement and compliance with MHPAEA has been a big issue driving the nation’s psychological well being disaster and substance use dysfunction epidemic, which have each been exacerbated by the pandemic.”
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