Mental Health Parity Rules: Finally Some Teeth for the Parity Act


The long awaited mental health parity rules are to be released soon. Although the mental health parity act has been around for a while, the rules were not promulgated when the act was passed which allowed insurance companies significant latitude in their interpretation and implementation of the act. Under the mental health rules, mental illness and substance abuse problems will be treated like a physical illness which was conveyed in the original act, but has long been undefined. The forthcoming rules that will address the issues around pre-authorization requirements and location of services which have been used to restrict access. Currently, people seeking mental health services, including outpatient may be subjected to extensive pre-authorization requirements, restrictions on the treatment and geographical limits which have prevented people from receiving treatment in another state. If a person needed cardiac treatment unavailable in their home state they could go out-of-state; a person seeking mental health treatment may not be allowed to seek treatment outside of their state. Under the forthcoming rules, a restriction like that would not exist.

We hope that the parity rules put some teeth into the Mental Health Parity legislation. Legislators see positive outcomes in addressing mental health treatment needs which previously were unmet and perhaps accounted for some of the extremely violent acts which have made the news lately. In reality, let’s hope that the Mental Health Parity Rules force insurance companies to treat mental health and substance abuse problems like physical ailments and not subject policy holders to restrictive and cumbersome rules which deny access to treatment. Interesting, is that the Medicaid and Medicare programs are not included in the forthcoming rules.

Click here to read the New York Times story:


Tag lines: mental health parity act, mental health treatment, substance abuse treatment, payment for mental health treatment, payment for substance abuse treatment

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.
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