New federal rule aims to push private insurers to expand mental health care

July 25 (UPI) — President Joe Biden on Tuesday proposed new federal rules that would force private health insurers to increase coverage for mental health services for millions of Americans who lack care.

The directive seeks to require insurers to make changes to benefits that were currently providing inadequate coverage and access to mental health care for more than 150 million people nationwide, the White House said in a statement.

The new rules require health plans to remove limits to mental health care by offering more services in-network and bar them from using restrictive authorizations and other back-channel techniques that make it harder for patients to access mental health and substance abuse services.

The policy change would also close existing health coverage loopholes and, for the first time, force private health insurers to comply with federal rules in an effort to expand mental care.

“Despite the repeated bipartisan efforts aimed at mental health parity, insurers too often make it difficult to access mental health treatment, causing millions of consumers to seek care out-of-network at significantly higher costs and pay out of pocket, or defer care altogether,” the White House said.

Biden was seeking to implement a comprehensive national strategy to transform how mental health is understood, accessed, treated, and integrated in and out of healthcare settings, the White House said.

To make the latest rule changes, the Biden administration cited the 2008 Mental Health Parity and Addiction Equity Act, which requires coverage of mental health services at the same level as physical health benefits.

In 2020, Congress updated the policy to require health plans to conduct meaningful analyses in an effort to balance physical and mental health services.

Despite the law, less than half of U.S. adults with diagnosed mental illnesses were currently receiving appropriate care, while fewer than one-tenth were getting any treatment for persistent substance abuse, the White House said.

“Today’s proposed rule would make clear that health plans need to evaluate the outcomes of their coverage rules to make sure people have equivalent access between their mental health and medical benefits,” the White House said. “This includes evaluating the health plan’s actual provider network, how much it pays out-of-network providers, and how often prior authorization is required and the rate at which prior authorization requests are denied. “

In many cases, those with private insurance were struggling to find viable mental health services in-network, while encountering long waiting lists for a scant number of options for therapy.

Previously, the Biden administration sought to expand access to mental health services covered by Medicare, while investing nearly $1 billion into the 988 suicide and crisis lifeline.

The administration recently updated rules that would make it easier for schools to bill Medicaid for mental health services.

Authored by Upi via Breitbart July 25th 2023