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Michael Petruzzelli

, National Council for Mental Wellbeing

New Parity Bill Aims to Hold Insurers Accountable for Behavioral Health Coverage

January 14, 2016 | Parity | Comments
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Congressman Joe Kennedy III (D-MA) has continued the work of his family, former Senator Ted Kennedy (D-MA) and Congressman Patrick Kennedy (D-RI), in ensuring that all Americans have access to quality behavioral health care. Through increased oversight and random annual audits, Rep. Kennedy aims to ensure that insurance providers are meeting their regulatory requirements in offering mental health services care at parity with medical care services.

The Behavioral Health Coverage Transparency Act (H.R. 4276) would require insurance providers to disclose the analysis they utilize in making parity determinations as well as the rates and reasons for mental health claims denials versus medical/surgical denials. It also would require the Department of Health & Human Services, the Department of Labor and the Department of Treasury to undertake a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws. Finally, it would establish a Patient Parity Portal, allowing consumers to easily access all publicly available parity information and submit complaints in a central online clearinghouse.

“Too many Americans suffering from mental illness are unable to access the treatment they need because their insurance company refuses to cover it – oftentimes with no explanation at all,” said Congressman Kennedy in a statement. “By boosting transparency and giving consumers more information, this bill would ensure insurance providers treat mental health and substance use disorders the same way they would a broken leg or heart disease. As we work to fill systemic gaps in our mental health system, holding insurers accountable for providing adequate mental health coverage is critical.”