Healthcare Parity Update

The healthcare bill that President Obama just signed into law has been the lead story on every news outlet and in every newspaper lately. But there’s a healthcare act that’s been getting plenty of attention in addiction treatment circles.

HR 1424 (aka the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act) has come to be known as The Parity Act. For years, coverage has been restricted for those seeking treatment for mental health and addictive disorders. The problem was rooted in prejudice and misinformation about the cost of treatment and the nature of mental illness and substance abuse.

Fortunately, studies have demonstrated the effects of parity increase costs by approximately 1 percent only, according to BehavioralHealthCentral.com. Also helping in the move toward parity is solid science indicating that mental illness and addictive disorders are diseases.

Parity Act Facts

Just as with other diseases and disorders, recovery from addiction and mental disease is possible when effective treatment is available. Money spent on treatment may also save the U.S. billions annually in the criminal justice, welfare and healthcare systems. So just what does the parity act accomplish? Here are a few of the highlights:

• Financial or treatment limitations must be made equal between medical, surgical and behavioral and addictive services, if a health plan covers mental health and addictive services.
• All plans are not required to provide coverage for behavioral and addictive services, but more than 90 percent of current employer-subsidized healthcare plans do provide coverage for behavioral and addictive services, and the requirements for parity apply to them.
• Employers with 50 or fewer employees and individually purchased health plans are exempt from the parity act.
• Out-of-network coverage for behavioral and addictive services must be consistent with out-of-network coverage for medical and surgical services.
• Health plans must disclose the criteria used to determine medical necessity and the rationale behind denials of any claims for behavioral and addictive services.

It’s estimated that 113 million Americans will be affected by HR 1424, and with more than 25 million untreated Americans with addiction, the parity act will allow them an opportunity to finally get treatment.

Rehab at The Canyon

If you or someone you love is suffering from a mental health or addiction disorder and are in need of drug treatment, call The Canyon at our toll-free number. Someone is there to take your call 24 hours a day and answer any questions you have about treatment, financing or insurance.