Important NAMI Survey: How is Your Health Insurance Treating You?

From NAMI Blog. By Everly Groves, NAMI Policy Intern and Sita Diehl, NAMI Director of State Policy and Advocacy. Dramatic changes now taking place in our nation’s health care system should mean that people living with mental illnesses will have better access to mental health services. But will they? NAMI created a brief online Coverage for Care Survey to answer this very question. We need your help to find out how recent changes in federal law affect you and your family.

Over 11 million people with mental illness were uninsured as of 2010. Most are now eligible for mental health and substance use care because of changes to health coverage under the Affordable Care Act (ACA). The ACA requires Medicaid expansion and individual and small group private health plans to cover mental health and substance use services as one of the 10 Essential Health Benefits. This change will mean that millions of people will be getting access to private health coverage or Medicaid for the first time.

Even more changes to mental health and substance use coverage came July 1. Provisions to the Mental Health Parity and Addiction Equity Act of 2008 were put in place to ensure parity for mental health and substance use care. But what exactly is parity? Parity ensures that all plans cover mental health and substance use treatment on par with other types of care. That means fair and equal terms for what types of services are covered, the procedures necessary to get care and how much you pay out of pocket.

Coverage for Care Survey
Because these changes are so important, NAMI wants to understand how the ACA and the new parity rules affect you and your ability to get the care you need. We created the Coverage for Care Survey to learn from you.

We want to hear from everyone in need of mental health or substance use care. So if you or your family member uses these services, complete this survey! It doesn’t matter if you have private health insurance, Medicare, Medicaid, TRICARE, VA health benefits, student health, any other type of coverage or don’t have coverage at all.

Take this survey on behalf of you or your loved ones in need of mental health and/or substance use care. Spread the word to your friends, family, co-workers, and colleagues. It should only take 15-20 minutes. Post the link on your Facebook or Twitter! The more responses we get, the stronger our findings will be.

The deadline to complete the survey is 12 p.m. EST on Sept. 30, 2014.

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Call Your Legislator in Support of Mental Health Parity

From NAMI California:

Dear NAMI Members:

Your help is urgently needed to support better enforcement of mental health and substance use parity laws in California!

As you may know, the Final Rule on Mental Health Parity was adopted last year, and enforcement of those parity regulations was delegated to the states. NAMI California has been working as a part of a broad coalition to ensure that funding for parity enforcement was included in the state budget. Our coalition was successful in getting parity proposals introduced!

There are two parity enforcement proposals before Assembly Budget Subcommittee #1 on Health and Human Services and the members of the Committee and the Chair need to hear your support today! (See calling information at the bottom of this message.)

Senator Jim Beall has made a proposal in the state’s budget process to augment and improve the budget of the Department of Managed Health Care so that it can better enforce both state and federal parity laws in California. Another budget augmentation proposal, this one by the Department of Managed Care Services, would also appropriate additional money the Department needs to start enforcing parity in California.

Senator Beall’s proposal adds more consistent surveillance of managed care plan activities, augments staffing for the Department, and requires annual reporting of enforcement activities. When these are added to the budget augmentation requested by the Department the two proposals together become very powerful to give the Department the tools it needs to robustly enforce parity mandates against discrimination in health care in California and to do so transparently.

Call your member on the Committee RIGHT NOW!!  Or, if your legislator is not on the Committee or you are calling for your affiliate, call the office of the Chair.  The proposal will be heard at 1pm tomorrow in the Sub Committee hearing so time is of the essence.   If you can’t call today, please call between 9am and 12 pm tomorrow morning.  Affiliates that can should also send a representative to the Sub Committee hearing tomorrow for oral testimony.

Tell them:

  1. You support BOTH proposals, the Department’s and Senator Beall’s.
  2. Make certain you are clear that Senator Beall’s proposal adds to, and does not supplant the Departments proposal     And that both individually are very good proposals, together they are terrific!
  3. Urge support for BOTH proposals when the item is considered by the Sub Committee tomorrow!

Here is a quick script you can follow:

“Hi, my name is ________, and I’m a member of NAMI (Affiliate). I’m calling to express my support for both the Department of Managed Health Care and Senator Jim Beall’s (pronounced Bell) budget proposal to enforce Mental Health Parity laws in California being heard tomorrow in Assembly Budget Subcommittee #1. Senator Beall’s proposal strengthens the Departments proposal by providing more resources for parity enforcement. I strongly urge your support!”

Assembly Budget Subcommittee #1 on Health and Human Services Contact Information

Member

District

Party

Phone

Chesbro, Wesley

2-Includes
Del Norte, Trinity, Humboldt and Mendocino counties, and Northern Sonoma
County.

916 319 2002 

Dickinson, Roger

7-Includes
Sacramento, West Sacramento, Natomas, Rio Linda, Elverta, Antelope and North
Highlands.

916 319 2007 

Grove, Shannon

34-Includes
Bakersfield,
Bear Valley Springs, China Lake Acres, Fellows, Frazier Park Golden Hills,
Inyokern, Lebec, Oildale, Ridgecrest,
 Rosedale, Taft,
Tehachapi,
Valley Acres

916 319 2034 

Mansoor, Allan

74-Includes
Costa Mesa, Huntington Beach, Irvine, Laguna Beach, Laguna Woods, Newport
Beach

916 319 2074 

Weber, Shirley (Chair)

79-Includes Mission
Valley, Grantville, Del Cerro, La Mesa, Oak Park, Encanto, Lemon Grove,
National City, Paradise Hills, Bonita 

916 319 2079 

Please call NOW!!!

If you have any questions please contact our Legislation and Public Policy Director, Caliph Assagai, Esq., at Caliph.Assagai@namicalifornia.org.

Thank you,

NAMI California Advocacy Department

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Administration issues final mental health parity rule

Administration says final rules break down financial barriers and provide consumer protections

The Departments of Health and Human Services, Labor and the Treasury today jointly issued a final rule they say increases parity between mental health/substance use disorder benefits and medical/surgical benefits in group and individual health plans.

The final rule issued today implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, and ensures that health plans features like co-pays, deductibles and visit limits are generally not more restrictive for mental health/substance abuse disorders benefits than they are for medical/surgical benefits.

The Administration states that today’s action also includes specific additional consumer protections, such as:

  • Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings;
  • Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law;
  • Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits and network adequacy; and
  • Eliminating the provision that allowed insurance companies to make an exception to parity requirements for certain benefits based on “clinically appropriate standards of care,” which clinical experts advised was not necessary and which is confusing and open to potential abuse.

In January, as part of the President and Vice President’s plan to reduce gun violence, the Administration committed to finalize this rule as part of a larger effort to increase access to affordable mental health services and reduce the misinformation associated with mental illness. The President and Vice President state that:

mental illness should no longer be treated by our society – or covered by insurance companies – differently from other illnesses.

“Americans deserve access to coverage for mental health and substance use disorders that is on par with medical and surgical care,” said Treasury Secretary Jacob J. Lew.  “These rules mark an important step in ending the disparities that exist in insurance plans, and will provide families nationwide with critical coverage and protections that fulfill their health needs.”

“New efforts are underway to expand coverage to the millions of Americans who have lacked access to affordable treatment for mental and substance use disorders,” said Labor Secretary Thomas E. Perez. “These rules will increase access to mental health and substance abuse treatment, prohibit discriminatory practices, and increase health plan transparency. Ultimately, they’ll provide greater opportunities for affordable, accessible, effective treatment to Americans who need it.”

The final Mental Health Parity and Addiction Equity Act rule was developed based on the departments’ review of more than 5,400 public comments on the interim final rules issued in 2010. The final rules may be viewed at https://www.federalregister.gov.

A fact sheet on the rules is available here: http://cms.hhs.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet.html.