House bill gives mental health equal coverage

AddThis

Texans are one step closer to accessing more equal coverage for mental health care and substance abuse following the House of Representative’s approval of House Bill 10, which gives these costs the same priority as physical health expenses.

The bill’s author, Rep. Four Price, R-Amarillo, said he filed the bill in hopes of resolving the barriers to adequate mental health care faced by many individuals in the state. Representatives voted 130-12 to tentatively approve the bill Tuesday.

“Eliminating differences in how treatment for physical and mental health conditions are reimbursed and administered will improve access to medically necessary treatment, improve mental health outcomes and help normalize treatment for mental health and substance use disorders,” Price said during the House’s session Tuesday.

Equating treatment of mental health and substance abuse conditions with that of physical conditions under insurance plans, referred to as behavioral health parity, became federal law in 2008, according to the Mental Health Parity and Addiction Equity Act.

Despite the federal law, many Texans still lack mental health care that is on par with the physical care benefits they receive from insurance companies, Price said. The state’s Department of

Insurance can currently ensure this equality only to large employer group health plans and is limited to regulating parity through quantitative measures such as number of visits per year and number of days covered for treatment.

Price said his bill seeks to align federal and state laws in order to expand coverage equality to all health plans and provide equal care in non-quantitative ways such as making preauthorization requirements for treatment less strict.

Additionally, Price said the bill provides a more straightforward way to report a parity compliance issue if a patient feels their insurance plan does not grant equality for mental health benefits.

Currently, patients or doctors concerned about most parity violations can only seek help from the federal government, but Price proposes adding an investigator in Texas to resolve complaints and track insurance companies to ensure they offer equality.

The bill also establishes a workgroup to further enforce compliance with the law and educate the public on the concept of parity. Under the bill, the state’s Department of Insurance would also be required to collect data from health plans to evaluate differences between mental and physical care.

Price’s bill still needs one more majority vote in the House before it is sent to the Senate for further consideration. Meanwhile, Sen. Judith Zaffirini presented an identical bill in a Senate committee meeting Tuesday morning. Zaffirini’s bill, Senate Bill 860, did not receive a vote and was left pending in committee.

Alison Boleware, policy fellow for UT’s Hogg Foundation for Mental Health, an organization that seeks to advance mental wellness and supports mental health parity, testified on Zaffirini’s bill during the committee hearing Tuesday.

“Individuals with mental health needs often face higher rates of denial for their mental health condition when compared to physical health care,” Boleware said during the hearing.  “Authorizing (Texas Department of Insurance) with the authority to monitor, regulate and enforce both (quantitative treatment limitations) and (non-quantitative treatment limitations) for all health plans in Texas could generate greater accountability and consumer protections for individuals attempting to access mental health care.”