In Huge Key Move, Feds Finally Issue Detailed Parity Regs

Addiction Treatment Industry Newswire

11/08/2013 -ATIN – After years and years of being mired in bureaucratic limbo, it appears that working out the specific implementation regulatory details of federal parity legislation is being fast tracked and that enforcement of those regulations, which are supposed to put addictions and mental health on an equal insurance reimbursement footing with medical surgical, has become a priority at the highest political levels in Washington. Driving the new sudden interest in specifically defining and enforcing parity by President Obama and his top advisors and lieutenants has been the explosion in senseless gun massacres committed by people who are mentally ill. Also, the “going live” of the ObamaCare insurance exchanges and parity aspects of the Affordable Care Act has also been a driver of high-level political interest in parity.

Rules Unveiled at Atlanta’s Carter Center

At a mental health conference sponsored and backed by former First Lady Rosalynn Carter, HHS Secretary Kathleen Sebelius will today unveil the new detailed rules governing access to residential and outpatient care by people with private health insurance. These rules have been awaited eagerly, and increasingly impatiently, by the addictions industry since the Wellstone Parity Act was passed in 2008 five long years ago. And mental health and addictions patient advocates are still saying that the release of today’s parity regulations from HHS is a “starting point” and much remains to be done.

Still a State-by-State Ballgame

And primary enforcement of the new parity rules is going to be placed in the hands of state insurance commissioners, who are currently overwhelmed with the technical intricacies of ObamaCare. State insurance commissioners also come from a wide variety of political backgrounds and belief systems, which means some commissioners may be inclined to play ball in strictly enforcing parity while others may be less so inclined and still others may be inclined to be downright obstructionist.

Likely Not an Addictions Residential Panacea

Because the sudden fast-tracking and increased profile of parity is being driven by the politics and media frenzy surrounding recent senseless gun massacres, the overwhelming focus is on the seriously mentally ill and, thus, on psychiatrics as opposed to addictions. And while the two are becoming increasingly integrated through dual diagnosis, the new regulations should not be seen as a panacea and a massive new opportunity for addictions providers on the residential side. Insurance companies are in no mood to suddenly open the residential cash spigots and will likely still have significant means and opportunity to push back when it comes to prior authorization, reimbursement, level of care decisions and stay lengths.

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