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Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.


Saturday, November 9, 2013

MHPAEA Addendum

Yesterday, in Parity or Parody, I posted about the new rules for the Mental Health Parity and Addiction Equity Act (MHPAEA).

A later article in the NY times, Equal Coverage for the Mentally Ill, states that, in fact, insurers ARE required to offer Mental Health and Substance (MH/Sub) coverage. This is not consistent with the government sites I referenced (DOL, CMS), but perhaps those sites hadn't been updated yet to reflect the new rules.

Regardless, I maintain that the excessively complicated details of the Act will make it possible for insurance companies to continue to restrict coverage for MH/Sub care.

I was struck by one paragraph, in particular, in the article:

The effect on costs is uncertain. Insurers fear that the expenses of high-cost inpatient treatment or long-term rehabilitation of patients suffering from mental health disorders or substance abuse will drive up insurance costs, but experts say the number of people receiving high levels of care will be too small to have a significant effect on overall costs. And in the long run, better care could cure enough people to save billions of dollars a year in medical costs, lost wages and reduced productivity associated with alcoholism and other addictions.

Who are we "saving billions" for? The article seems to make the assumption that the interests of insurance companies coincide with those of the government, and the people. Myself, I don't believe insurers care about lost wages and reduced productivity, especially if it means a dent in their bottom line.

And I don't even know where to start with the phrase, "Better care could cure enough people to save billions of dollars a year." Key words here include "could", "cure", and "better".

(Here's a link to the Final Rule. Good luck reading it.)