The Parity Bill Is Here

There has been much debate about the healthcare bill that President Obama recently signed into law, but there’s a healthcare act that already went into effect this year and is big news in addiction treatment circles.

The Parity Act

The Parity Act (also called HR 1424 or the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act) seeks to equalize coverage for those seeking treatment for mental health and addictive disorders. For years, there have been restrictions on this treatment that didn’t apply to other disorders, keeping those in need from getting the help they needed. The problem was rooted in prejudice and misinformation about the cost of treatment and the nature of mental illness and substance abuse.

Studies have since demonstrated the effects of parity increase costs by approximately one 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. Just as with other diseases and disorders, recovery from addiction and mental disease is possible when effective treatment is available, and the truth is that money spent on treatment may also <I>save</I> 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.

Dual Diagnosis Treatment

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. If you were denied treatment prior to January 2010, contact La Paloma at our toll-free number to see if your coverage options have changed. Someone is there to take your call 24 hours a day and answer any questions you have about treatment, financing or insurance.