Wednesday, December 9, 2009

Bailout

What did you get out of the Bailout? Most likely you are saying nothing!

One of the things that was slipped into the $700billion bailout that most people aren't aware of is the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) President Bush signed the Act On October 3rd, 2008 and it went into effect on October 3rd, 2009. The House of Representatives passed it 263-171 This Act will affect you or someone you know whether you'd like to admit it or not.

For calendar year insurance plans, the effective date is January 1, 2010. It applies to insurance plans with coverage for 50 or more employees. So small business owners are exempt, which is similar to FLMA protection. Just in case you were wondering why your insurance premiums are going up January 2010 this would be one of the reasons.

The Act generally requires equity in treatment of mental health and substance abuse treatments under a plan. They have to be treated as a regular medical condition.

-Plans cannot generally impose more restrictive lifetime or annual limits on mental health or substance use disorder benefits that those imposed on medical or surgical benefits.

-Plans cannot generally impose more restrictive financial requirements, such as co-pays, deductibles, coinsurance or out-of-pocket expenses, on treatment for mental health or substance use disorder benefits than apply to medical or surgical benefits.

-Plans cannot generally impose more restrictive limitations on the frequency or total use of mental health or substance use disorder benefits that medical or surgical benefits.

-The Plan must provide similar in-network and out-of-network benefits for all coverages.

-The Plan must clarify and make available to participants the criteria used for determining medical necessity of mental health and substance use benefits.
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Put another way, insurers will no longer be able to limit the number of visits or charge higher deductibles and co-payments for mental health and substance abuse services.

“If you have insurance, then your mental health care must be equal to the benefits you get for any other disease,” said Sen. Pete Domenici (R-N.M.), quoted in a Reuters article. His daughter has schizophrenia.

2 comments:

Anonymous said...

You are a real work of art.

Leia Organa said...

Thank you for the compliment!