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A Step Closer to Strong Parity Enforcement

     

Today psychiatrists and patients moved a step closer in our fight for being treated like the rest of medicine.

You may have heard that, today, the U.S. Court of Appeals for the Second Circuit remanded a decision about whether the New York State Psychiatric Association (NYSPA), APA’s chapter in the Empire State, is able to bring suit against UnitedHealth Group for failure to provide coverage of mental health that was equal to coverage for other medical services. Congratulations are due to NYSPA for this victory.

Here are the two reasons why this ruling is a win:

  1. The court said that NYSPA could represent its members and their patients in pressing a claim under the Mental Health Parity Act through “Associational Standing.”
  2. The court said that an insurer could be sued even when it was acting as the administrator of a self-insured plan. United argued that because it was not the insurer, the plaintiffs had to sue their employers, and we can all imagine how difficult that could be for an employee.

Since the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008, some health plans have made efforts to comply with the parity law, but many still have not. NYSPA has done a wonderful job for our members and patients, and the profession of psychiatry by bringing these issues to the court’s attention.

This is not the only case involving the parity law. APA and others filed suit against Connecticut’s Anthem Health Plans regarding certain non-quantitative treatment limitations, which APA and the other amici (“friends of the court”) say violate MHPAEA. This case will appear in the same court on September 21.

Think about how prominent mental health issues are in our country and in the headlines these days. It stands to reason that mental health parity is crucial to the overall health and wellbeing of our nation. We must take our fight to every place that could help our patients and our profession increase access to care. While as many as one in five adults in the United States has a diagnosable mental disorder, only 38 percent of adults who need mental health treatment receive it. The promise of parity is that, when you have insurance, your insurer must treat mental illness fairly and equitably.

APA is working tirelessly to advance parity: Since patients who know their rights are better able to defend their rights, we developed a new tool – our Parity Poster – intended to educate patients, families and employers. It’s also in Spanish. Now patients will know what constitutes a violation and what to do about it. We’ve also brought greater attention to parity at the U.S. Department of Labor, to state attorneys general, and to major employers – and we are finding many people are interested to help.

I will keep you posted as your APA fights on for strong parity enforcement.


What APA is Doing for You

This blog post is part of an occasional series highlighting how APA advocates on your behalf to support the profession of psychiatry and put our interests before key policymakers.

     

Post by Saul Levin M.D., M.P.A.

Saul M. Levin, M.D., M.P.A., is APA's CEO and Medical Director. Read Dr. Levin's full biography

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CEO BlogWhat APA is Doing for You

 

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