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White House Boosts Coverage for Mental Illness

Enforcement of 2008 law requires insurers to treat mental illness the same as physical illness

WebMD News from HealthDay

By Steven Reinberg and Margaret Farley Steele

HealthDay Reporters

FRIDAY, Nov. 8 (HealthDay News) -- U.S. health officials unveiled long-awaited rules Friday that require insurance companies to cover treatment for mental illnesses and addiction the same way they cover physical illnesses.

Secretary of Health and Human Services Kathleen Sebelius, who announced the regulations at a health conference in Atlanta, said this is "the largest expansion of behavioral health benefits in a generation."

The regulations will make the 2008 Mental Health Parity and Addiction Equity Act a reality, and fulfill a generation-long effort to improve benefits and treatment for people with mental health issues or substance abuse problems.

Co-pays, treatment limits and deductibles can't be more stringent for people with mental illness than for people with a physical illness, under the new rules. This means insurance providers "can't say you can only get substance-abuse treatment in state but you can go anywhere for medical/surgical" treatment, a senior Obama administration official told The New York Times, which broke the story on Friday.

Nor can insurers deny coverage for someone with a history of depression, attention-deficit/hyperactivity disorder, anxiety or other common conditions, mental health experts said.

An estimated one-quarter of Americans have some form of mental illness, according to the U.S. Centers for Disease Control and Prevention.

This "incredibly important law, combined with the Affordable Care Act, will expand and protect behavioral health benefits for more than 62 million Americans," Sebelius said. "People who either have insurance coverage now and have no mental health coverage or where the Affordable Care Act fills in those gaps for people who have no insurance at all, they will be able to access affordable care."

Mental health advocates welcomed Sebelius' announcement.

People with mental illness have long faced discrimination in health care through unjust and often illegal barriers to care, Dr. Jeffrey Lieberman, president of the American Psychiatric Association, said in a statement. This final rule "provides a crucial step forward to ensure that patients receive the benefits they deserve and are entitled to under the law," he said.

Lieberman added he is hopeful there will be strong monitoring and enforcement of the law by states and the federal government.

Dr. Victor Fornari, director of the division of child/adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y., said, "We have been fighting for parity for a very long time."

The way Fornari views it, "Every effort to have increased access to health care, including mental health care, is progress in a civilized society."

The rules will affect most Americans with health insurance, including health plans bought under the Affordable Care Act of 2010. However, the regulations may not apply to people covered by Medicaid, the publicly funded insurance program for the poor, or Medicare, which provides coverage for seniors, the Times reported.

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