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November 9, 2013

New rule demands parity for mental health coverage

WASHINGTON (AP) — It’s final: Health insurance companies now must cover mental illness and substance abuse just as they cover physical diseases.

The Obama administration issued new regulations yesterday that spell out how a 5-year-old mental health parity law will be administered.

Health and Human Services Secretary Kathleen Sebelius said the rule should put an end to discrimination faced by some mental health patients through higher out-of-pocket costs or stricter limits on hospital stays or visits to the doctor.

The law, signed by President George W. Bush, was designed to prevent that. But mental health advocates said health insurers at times sidestepped lawmakers’ intentions by delaying requests for care and putting in place other bureaucratic hurdles. They described the new Obama administration rule as necessary to ensure patients get benefits they are entitled to receive.

The administration had pledged to issue a final mental health parity rule as part of an effort to reduce gun violence. Officials said they have now completed or made significant progress on 23 executive actions that were part of a plan announced in response to the school massacre in Newtown, Conn., last December.

The 2008 mental health parity law affects large group plans. The Affordable Care Act requires individual and small group plans to treat mental health and substance abuse coverage the same way physical illness coverage is treated.

“For way too long, the health care system has openly discriminated against Americans with behavioral health problems,” Sebelius said in a telephone conference call with reporters. “We are finally closing these gaps in coverage.”

Sebelius said that access to mental health coverage had already been improving since passage of the mental health parity law. She noted that larger employer health insurance plans already have eliminated higher cost-sharing for inpatient mental health care and said most plans have done the same for outpatient care.

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