IL Graded “C” on Mental Health Parity Law; Advocates Join National Compliance Push

(Springfield, IL) – Next year will mark the 10th anniversary of landmark federal legislation providing insurance parity for mental health and addiction treatment, but lagging enforcement in Illinois and elsewhere around the country has pushed state behavioral health advocates to join a national compliance campaign to “jumpstart” the law and nudged state lawmakers to launch a probe of parity gaps.

“On the U.S. Mental Health Parity and Addiction Equity Act, Illinois gets a “C” on enforcement,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe, who will lead Illinois’ compliance effort. “Too often, insurance companies get away with denying care to individuals struggling with mental illness or addiction. That’s why we are joining a national effort to pursue full enforcement of the law.”

Illinois and four other states – Maryland, New Jersey, New York, and Ohio – form the vanguard of the Parity@10 Compliance Campaign, a three-year, 10-state push to ensure that the federal law lives up to its promise nationwide.

Spearheading the campaign nationally are the Legal Action Center, The Kennedy Forum, The National Center on Addiction and Substance Abuse, Partnership for Drug-Free Kids, and the Research & Evaluation Group at Public Health Management Corporation.

“The campaign is ready to jumpstart parity enforcement,” said Ellen Weber, vice president for health initiatives at the Legal Action Center and the director of the campaign. “Achieving more robust parity compliance in 10 states over the next three years will not only benefit millions of people living in those states, but will also establish models that can be adopted by other states.”

Howe says that the campaign’s goal in Illinois is to ensure that insurance carriers and State Medicaid programs offer fully parity compliant substance use and mental health benefits and that regulators end complaint-driven enforcement models that put the onus on consumers.

“Generally, insurance plan documents fail to provide sufficient information for consumers to determine whether coverage complies with the law or not, which stifles complaints, and without consumers filing complaints regulators are unable to act,” said Howe. “The system is rigged in favor of insurance companies, not consumers. That’s why we need proactive enforcement that empowers regulators to police insurance companies before their plans are sold.”

Howe says that in Illinois, the campaign will work with lawmakers, regulators, and the Attorney General to develop more effective compliance and enforcement frameworks.

Howe noted that a September 2017 report by the Kennedy Forum, with whom Howe’s group collaborated, revealed that 75 percent of Illinois behavioral health providers surveyed reported that Medicaid Managed Care Organizations “sometimes/often/always” denied coverage for mental health and addiction inpatient and outpatient treatment, among other services, prompting State Rep. Steve Andersson (R-Geneva), member of the House Mental Health Committee, to file a resolution urging action to address the report findings.

Meanwhile, the House mental health panel will hold a hearing in Chicago on December 4 to launch its own investigation of mental health and addiction treatment service “barriers” experienced by community behavioral health providers.

IABH’s work with The Kennedy Forum on the report and on other parity initiatives lead the national Parity@10 Compliance Campaign organizers to select Illinois in the effort’s roll out.

“Illinois is one of five states selected to launch the campaign based on the work the Illinois Association of Behavioral Health (IABH) and The Kennedy Forum Illinois have been doing to advocate for comprehensive health insurance coverage of mental health and substance use disorders,” said the Legal Action Center’s Weber.

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