NYAPRS Note: The below article indicates that NY health plans and employers are “ahead of the pack” in terms of parity for behavioral health services. When management of these services expands to Medicaid beneficiaries in 2015, this will hopefully contribute to a smoother transition due to the provider networks and management capacity already in place. While the willingness to manage behavioral health services is essential, it is also imperative that health plans respond to the diverse needs of expanded communities eligible for care.
Mental Health Support in N.Y.
Democrat & Chronicle; 2/17/2014
Few would argue that the federal health care reform law has even come close to being the cure-all for the nation’s health insurance ills that it was meant to be. Nonetheless, there are undeniable signs of progress.
Take the area of mental health, which is often linked to violence and drug abuse. Under the Affordable Care Act, coverage is now among 10 “essential benefits” for health insurance plans sold on public health care exchanges.
What’s particularly significant is that for the first time, people on Medicaid, the health insurance program for the poor and disabled, will have full access to mental health services.
The health care law requires insurance companies providing individual and small group policies to make available mental health coverage that is comparable to that for physical ailments. And insurers can’t do it by charging higher co-pays or deductibles than they would for medical visits. Restrictions on mental health visits are also prohibited.
Those parity provisions make up the core of the 2008 federal Mental Health Parity and Addiction Equity Act, which finally becomes effective for most plans on July 1 now that implementation rules were issued last November. One overdue rule, for instance, makes it clear that residential treatment or intensive outpatient therapy is covered.
Back to the ACA. Though the 2010 law’s mental health provisions don’t apply to companies with 100 or more employers, in New York that isn’t a problem.
Rochester-based Excellus, which has 1.8 million subscribers in upstate New York, estimates that at least 90 percent of its customers are covered for mental health and addiction treatment services.
This situation speaks well for major employers in the state, who voluntarily offer mental health coverage. They are a big reason why upstate New York has an uninsured rate of 8.4 percent, which is better than 47 other states.
Credit Timothy’s Law, too, for New York being in the forefront for providing mental health coverage. Former Gov. George Pataki signed the law requiring mental health parity in December 2006 and it became effective Jan. 1 of the following year.
With the expansion of mental health parity to the poor under the ACA, New York is moving ahead even further to ensure that citizens who might need coverage get it. On this score, New York can truly hold its head high as the Empire State.