New Rule Requires Parity For Mental Health Coverage

WASHINGTON (November 8, 2013) A new rule the Obama administration pledged to issue as part of the effort to reduce gun violence requires insurers to cover treatment for mental health and substance abuse just as they do for physical illness.

The rule puts legislation signed into law five years ago into effect.

Patients seeking mental health or substance abuse care have at times suffered discrimination through higher out-of-pocket costs or stricter limits on hospital stays or visits to the doctor, Health and Human Services Secretary Kathleen Sebelius said Friday.

Sebelius says nearly 60 percent of people with mental health conditions and nearly 90 percent with substance abuse disorders don't receive the treatment they need.

“This final rule breaks down barriers that stand in the way of treatment and recovery services for millions of Americans,” said Health and Human Services Secretary Kathleen Sebelius.

“Building on these rules, the Affordable Care Act is expanding mental health and substance use disorder benefits and parity protections to 62 million Americans. This historic expansion will help make treatment more affordable and accessible.”

The rule also establishes consumer protections including application of parity to intermediate levels of care in residential treatment or intensive outpatient settings; clarification of the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law; clarification that parity applies to all plan standards, including geographic limits, facility-type limits and network adequacy, and elimination of an exception to the existing parity rule that was determined to be confusing, unnecessary and open to abuse, the government said Friday.

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