Good news for patients seeking care at residential treatment or intensive outpatient care centers
Reprinted from Eating Disorders Review
November/December Volume 24, Number 6
©2013 Gürze Books
A new ruling by the Department of Health and Human Services (HHS) brings a welcome change to healthcare coverage for patients with eating disorders. On November 8, the HHS announced changes to the Mental Health Parity and Addiction Equity Act of 2008. While the final ruling doesn’t require that residential services be covered, it does stipulate that if a managed care organization or health insurer offers “post-acute care services,” then it must also cover residential treatment and other intermediate behavioral health services. Thus, if a health insurance plan covers, for example, chemotherapy (a post-acute oncology intervention after hospitalization), then it must also cover residential treatment for substance abuse disorders or eating disorders. The new ruling thus ensures that parity of coverage apply to intermediate levels of care given in residential treatment centers or intensive outpatient care centers.
In the new ruling, parity applies to all portions of a health plan, including geographic limits, family type limits, and network adequacy. According to Labor Secretary Thomas E. Perez, the new rules will increase access to mental health and substance abuse treatment, prohibit discriminatory practices, and increase health plan transparency. Ultimately, he noted, they’ll provide greater opportunities for affordable, accessible, effective treatment to Americans who need it.
The final Mental Health Parity and Addiction Equity Act rule was based on the HHS’s review of more than 5,400 public comments on the interim final rules issued in 2010. The changes also followed two years of continuous lobbying by the Eating Disorders Coalition, which worked to clarify that eating disorders must be covered at parity.
For more information
The final rules may be viewed here. In addition, a fact sheet on the rules is available here.