New Tools and More Advocacy Needed To Improve Access to Treatment for Substance Use Disorders and Mental Illness

Dear Partners:

Consumers now have new tools to help advocate for access to critical substance use disorders and mental health treatment. The final report of the federal Mental Health and Substance Use Disorder Parity Task Force provides resources for consumers, advocates and policymakers to help ensure access to treatment for these conditions is on par with that for any other health issue.

Here are some highlights and how you can use them:

  • $9.3 million in federal grants to 20 states (CA, CO, DC, HI, IL, IN, MA, MD, MI, MN, MS, NC, NE, NH, NM, NY, OR, PA, RI, and UT) to help state regulators ensure parity compliance. Brief descriptions of how states plan to use the grants can be found here. Advocates can work with their Departments of Insurance to help inform their work and educate these policymakers on ways to best help consumers.
  • A federal website to help consumers find the appropriate state and federal agencies to address potential parity violations is currently in beta form. The website is fairly bare-bones now, but includes an opportunity to provide input on how the site can be built out. Advocates can suggest how the site could be used to collect complaints/appeals and forward them to the appropriate agencies, track data and trends, and link to sites such as ParityTrack.org that provide consumer-friendly information on parity. Also, click on the federal website’s bullet points for individual private insurance or for Medicaid, select your state and check if the link to help is appropriate. You can also make recommendations on how to improve users’ experience and their ability to get the information they need.
  • The release of the Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits. This guide for consumers and providers describes what information insurance plans must disclose regarding what they cover, how they make decisions about coverage as well as how to obtain documents consumers may need for a parity complaint. It includes 11 specific scenarios. Advocates can help get this information out to providers and use it to help consumers who are not getting the services they need.
  • More guidance to states and health plans to help identify policies that violate the parity law. For example, this guidance clarifies that requiring in-person prior authorization for inpatient mental health or substance use treatment while requiring only phone authorization for other inpatient treatment would be a parity violation. Advocates can bring this and other guidance to the attention of providers and insurers in their communities.

For more details on the Task Force’s other actions and recommendations, please see this 4-page description from our partners at the Parity Implementation Coalition. While we applaud these actions, more steps are needed to ensure robust compliance with the Mental Health Parity and Addiction Equity Act. We do not know how the Trump administration will approach parity issues. We hope advocates will join us and other partners as we work to:

  • Obtain support for a national education campaign by the substance use and mental health community to explain parity rights and how to report violations
  • Press insurers to post easy-to-understand parity information on plan documents and websites
  • Urge state and federal authorities to require insurers to prove parity compliance before their products are approved for marketing, and to conduct random audits of insurers’ parity practices
  • Encourage the federal Departments of Labor, Health and Human Services and Treasury to issue more guidance to states on how to conduct parity audits and types of insurer policies that violate the law 
  • Urge Congress to authorize the Department of Labor to fine noncompliant insurers, as the Task Force recommends

Community Catalyst is excited to work with state advocates in the continued fight for equal access to treatment for people living with mental health and substance use disorders. If you have questions or require assistance with parity issues in your state, please contact Aryka Chapman at achapman@communitycatalyst.org.

We thank you for all of your efforts!
Alice Dembner

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