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The Politics of Healthcare

States Finally Focusing on Mental Health Funding & Programs

Published February 6, 2012 3:02 PM by Kelly Bocich

By Michael LaMagna

With an estimated 26 percent of U.S. adults experiencing a mental disorder at some point in their lives, mental illness affects most people and almost every family. In 2008, a law was passed, the Mental Health Parity and Addiction Equity Act (MHPAEA), which required large group health insurance plans (those with more than 50 insured employees) that provide mental health services to provide coverage on the same level as other medical and surgical benefits. This includes a prohibition on charging separate coinsurance, deductibles or limiting out-of-network coverage. In addition, many states have parity laws aimed at providing mental health benefits and protections beyond MHPAEA. The federal parity law makes clear that state laws that provide greater protections than the federal law continue to remain in effect.

As expected, when funding gets tight, there has been a reduction in many mental health coverage options, especially regarding plans not covered under MHPAEA. In Iowa, California, Pennsylvania and Connecticut, there are proposed bills, viewed as national models, which will redesign how services to the mentally ill are provided and require insurers to cover the diagnosis and treatment of mental illnesses, and developmental disorders such as autism. Moreover, pilot programs are being developed that would utilize thousands of community help workers to hit the streets to aid the mentally ill, which very often are in the shadows.

More specifically, the proposed legislation will increase coverage for the mentally ill, including funding for:

  • Self-help centers run by other people with mental illness or disability;
  • Crisis services for people with psychiatric needs;
  • Residential services for people who need assistance, but don't need hospitalization;
  • Jail-diversion efforts to keep people from being jailed for behaviors sparked by mental illness;
  • Community treatment, support services, case management, and supported community living and family services;
  • Employment and education services; and
  • Transportation.

Although the status of the legislation is unsure, at least the conversation at a State and national level has started.

This article is provided for informational purposes only. Nothing in this article shall be construed as legal advice or should be relied upon as such. Michael LaMagna is a partner at Timins & LaMagna, LLP, practicing Health Care Regulatory, Elder /disability/veteran's law, trusts and estates, Social Security and general legal practice in both New York and Connecticut. Michael was just appointed to the ACO Task Force of the American Health Lawyers Association. Email him atMlamagna@nyandctlaw.com, call him at 914-819-0663 or visit Attorney LaMagna's website at www.nyandctlaw.com for more information.

posted by Kelly Bocich


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