APA testifies on need to protect mental health benefits

The law that keeps health plans from imposing limits on mental health benefits is being undermined by managed care.

By Lisa Rabasca
Monitor staff

Managed-care companies are still finding ways to limit coverage of mental health despite the Mental Health Parity Act, according to a new report to Congress.

'We are concerned that managed-care strategies are being used to limit access to mental health care otherwise made available by parity,' said Russ Newman, PhD, JD, APA?s executive director for professional practice, at a July 15 press conference.

Newman was one of several parity law supporters to speak at the Capitol Hill event, as the report, prepared by the National Institute of Mental Health, was made public. 'Whether it?s lack of equality between mental and physical health benefits,' Newman said, 'or a managed-care plan containing costs by denying necessary health care?particularly mental health care?it is still discrimination.'

Senator Paul Wellstone (D?Minn.), the law?s co-author, said at the press conference, 'This report provides further evidence that parity must be accompanied by accountability in order to ensure quality of mental health care.' Senator Pete Domenici (R?N.M.), the law?s co-author, also spoke at the press conference.

The proportion of patients receiving mental health treatment after parity legislation was enacted has varied considerably in health plans that use managed- care procedures, according to the report.

Health plans using managed-care strategies found that implementing parity increased their cost by less than 1 percent, the report found. The report focuses on three states that enacted mental health parity with managed care:

? In Texas, parity resulted in a 50 percent reduction in the cost of mental health services for state employees.

? The cost of implementing parity in Maryland was minimal. A study of five private managed-care companies reveals that during the first and second years of parity, the cost of mental health treatment rose by 0.84 percent of overall benefit costs. But, by the third year, the cost had dropped to 0.27 percent of overall benefit costs.

? Mental health costs for state employees dropped 32 percent after North Carolina enacted parity.

Newman urged policy-makers not to integrally link parity with managed care. 'If parity is driven by cost, rather than need, its success will be negated,' he said.