Making Parity a Reality

by Erik Stone 24 July 2012 09:14

Everyone knows that health care reform is a big, big thing.  Or should know.  I’m always surprised by those who aren’t paying attention.  As Biden said, it’s a BFD.  But I digress.  One piece of health care reform is parity.  Officially known as the Mental Health Parity and Addiction Equality Act, the parity law went into effect in 2010. It requires most insurance plans that pay for treatment of substance abuse disorders to provide that coverage with requirements and limitations similar to those for medical/surgical benefits.  So, no greater financial requirements such as co-pays, deductibles, annual or life-time dollar limits. No greater treatment limitations such as the number of visits than the plan applies to substantially all medical/surgical benefits. 

To give examples, if the plan does not require co-pays for medical visits, co-pays cannot be required for addiction treatment visits.  If prior authorization is not required for medical visits, prior authorization cannot be required for addiction treatment.  Sounds good, right?  Well, the cynical among us think that the insurance companies will be creative and find other ways to deny/limit coverage.  I’m more positive, but human nature is what it is.  If no one pays attention, people tend to do what they want.  So, how can you follow this issue?  Check out the Parity Implementation Coalition at http://parityispersonal.org/  Good information on what you can do to help make sure insurance companies follow the law.  And several congressman are holding a series of hearing on parity implementation.  Next is Chicago on August 6 and then September 18 in Los Angles. More details at the Parity Implementation Coalition.

Parity is something we wanted for years.  Now it’s up to us to make sure the law is followed, comprehensively and effectively.