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Dear CSWA Members,
As you know, CSWA has been involved in the Mental Health and Substance Use Disorder Parity Task Force (MHSUDPTF ) created in March, 2016, by President Obama. The goal of this Task Force is to look at the overall failure to enforce the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The Rules for MHPAEA, which become the basis for enforcement, were not implemented until 2014.
Today the MHSUDPTF issued its report. In addition to the 34-page report that was released, there was a 20- page report for consumers about their rights to mental health and substance use treatment. Both are worth reading. The authors of the Report, in addition to the President, included Departments of Treasury, Defense, Justice, Labor, Health and Human Services, Veterans Affairs, Office of Personnel Management, and Office of National Drug Control Policy. The comments submitted to the Task Force by CSWA can be found at the CSWA website (www.clinicalsocialworkassociation.org) .
To find the Report go to http://www.hhs.gov/sites/default/files/mental-health-substance-use-disorder-parity-task-force-final-report.PDF
To find the Consumer Guide go to http://store.samhsa.gov/shin/content//SMA16-4992/SMA16-4992.pdf
While this is not a complete answer to the problems that many CSWA members and our patients have faced with coverage, it is a help. Remember that the Federal Government has oversight for ERISA – self-insured – plans. Private insurance plans, like Blue Cross, United, Aetna, etc., are overseen by the Insurance Commissioners in each state. This report only applies to ERISA plans, though it is likely to have an impact on private plans.
Members may have a special interest in #4 of the Consumer Guide which addresses how usual and customary out of network reimbursement rates are determined and how they can be questioned.
As always, please let me know if you have any questions about these documents.
Laura W. Groshong, LICSW, Director, Policy and Practice
Clinical Social Work Association
CSWA - "The National Voice for Clinical Social Work"
Strengthening IDENTITY, Preserving INTEGRITY, Advocating PARITY
PO Box 10, Garrisonville, Virginia 22463 | 202-203-9350 | firstname.lastname@example.org