MHA Society for Behavioral Health

Mental-health parity bills OK'd; next step unclear

Behavioral health advocates moved a step closer to watching mental healthcare coverage parity become law, but they’re not quite there yet. Both houses of Congress have passed versions of mental-health parity legislation that would require private insurance plans that offer mental health benefits in their coverage to do so at the same level as medical-surgical benefits. For example, plans could not cover mental-health expenses at 50% and cover medical costs at 75%.

While the Senate voted 93-2 to include the measure as a 10-year, $3.9 billion provision in its Renewable Energy and Job Creation Act of 2008, also called the tax extenders bill, the House passed its version, in a 376-47 vote, as a separate, stand-alone bill. Experts have said it’s unclear what will happen next before a bill can be sent to the White House for the president’s signature.

“They’re going to have to push it back and forth between the two to (reach) agreement,” said Mark Covall, executive director of the National Association of Psychiatric Health Systems, which represents both for-profit and not-for-profit behavioral healthcare providers, including about 300 hospitals. Covall said either the Senate’s tax extenders bill could go to the House, which could make changes and send it back to the Senate, or the House’s free-standing bill—which did not include a specialty hospital provision that had physician ownership proponents worried—could be sent to the Senate.

[ via Jessica Zigmond, Modern Healthcare's Daily Dose ]

House Leaders Say They Will Consider Mental Health Parity as Stand-Alone Bill This Week

House leaders on Sept. 19 told mental health lobbyists that mental health parity legislation will be taken up as a stand-alone bill this week under suspension of the rules, a procedure that prohibits amendments and requires a two-thirds majority for the bill to pass, CongressDaily reports. Lawmakers reached an agreement in July that would combine the House and Senate mental health parity bills by removing a House mandate on coverage of specific mental health conditions in favor of one that would require that mental health benefits be equal to physical health benefits.

No funding mechanism was included in the agreement. The $3.4 billion House measure will be offset by taxes and restrictions imposed on physician-owned hospitals, according to lobbyists.

The restrictions, taken from a Senate bill passed earlier this year, are less strict than those originally passed by the House. House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) warned that the restrictions could become harsher if negotiations on the bill continue into next year.

A House leadership aide said, "Since it is unclear what the Senate is going to send up with respect to their tax package, we are keeping our options open as we head into next week." The Senate last week said it would include the parity bill in a tax extenders bill (S 3001), although the package "faces hurdles in the House" because portions of it do not have funding offsets.

Andrew Sperling, a lobbyist with the National Alliance on Mental Illness, said, "We have to be respectful of the fact that the House has its rules," adding, "No one is questioning the commitment of leadership to get mental health parity done." Senate Banking Committee Chair Christopher Dodd (D-Conn.) on Sept. 18 said the Senate has decided to name its parity bill the "Wellstone-Domenici bill," after Sens. Paul Wellstone (D-Minn.), who died in 2002, and Pete Domenici (R-N.M.). The senators "championed" the first parity bill, passed in 1996, CongressDaily reports (CongressDaily, 9/18).

   

Senate Finance Committee Members Push for Compromise on Mental Health Parity Legislation

The Senate Finance Committee has begun discussing potential funding offsets for a compromise on mental health parity legislation passed by the House and Senate earlier in the 110th Congress, CongressDaily reports. Lawmakers reached an agreement in July that would combine the House and Senate bills by removing a House mandate on coverage of specific mental health conditions in favor of one that would require that mental health benefits be equal to physical health benefits, although no funding mechanism was included in the agreement.

Senate Finance Committee Chair Max Baucus (D-Mont.), when asked about the bill's chances of passing this month, said, "The funnel is so small, there's so little time and there's so much we have to pass here," adding, "I'll hope." Rep. Patrick Kennedy (D-R.I.), who is expected to meet with House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) to discuss the compromise, said the bill must receive final approval this month before attentions shift to the November elections. Kennedy said it is a "good bipartisan, bicameral compromise bill" and has secured "a sign-off from both business and consumer groups," adding, "[I]t's just hard to think that you're going to be able to get that kind of sign-off and political compromise back again without a lot of footwork."

Kennedy also said there is a chance that business groups would withdraw their support for the parity legislation if it has to start from scratch next year. National Retail Foundation Vice President and Employee Benefits Counsel Neil Trautwein said, "I think we are in a very delicate position right now." He added, "The fact that we've been able to work the issue to this extent is incredible. Could you recreate if you had to this coalition in the next Congress? I would hope so, but by that time other extraneous issues could get in the way."

Mental health advocacy groups on Sept. 10 coordinated efforts with their memberships to begin lobbying lawmakers to push the bill through this month. The groups will rally in Washington, D.C., on Sept. 17 and are discussing placing advertisements in Capitol Hill publications over the upcoming weeks.

[ via Kaiser Daily Health Policy Report ]

Telepsychiatry Helps Address Mental Health Worker Shortage

The use of telepsychiatry is increasing in the U.S. as the country faces a shortage of qualified mental health professionals. Texas, considered a nationwide leader in telepsychiatry, uses the technology to provide mental health care in rural areas, address the shortage of child psychiatrists and treat prison inmates.

For the full story, click here.

Study: Legal risk for prescribing painkillers not significant

Lately, legislatures and regulatory authorities have been paying a lot of attention to the prescription of painkillers, noting that some can kill if prescribed irresponsibly and that other opioid may be diverted for addictive use. Not surprisingly, such has made some physicians afraid to prescribe opioids at all. In fact, primary care doctors say the biggest obstacle they face in prescribing opioids to treat chronic pain is scrutiny from regulators and law enforcement officials, a recent survey found.

The thing is, PCPs' fears are misguided, according to a new study appearing this month in the journal Pain Medicine. Researchers, who reviewed nine years of medical board and local, state and federal law enforcement charges against doctors for improperly prescribing opioids, found that very few resulted in any real problems for physicians. In fact, only 725 doctors - or one-tenth of one percent of practicing physicians - were accused of criminal or administrative offenses during the period studied, 1998 to 2006.

It's worth noting, however, that the study has some harsh critics. They contend that the number of doctors who get investigated is much larger than the number who are actually charged. They note that fear of being investigated, even if that investigation is unlikely to lead to charges, is enough to chill physicians' use of painkillers anyway. And that, say pain management specialists, means that physicians may refuse to treat patients that have severe chronic pain with the high doses they need to get relief.

To learn more about the study, read this AMNews piece.

[ via Fierce Healthcare ]