BOTTOMS: Practical ramifications of Georgia’s new mental health law

With rare unanimous votes in the Georgia House and Georgia Senate, Georgia's House Bill 1013, titled the Mental Health Parity Act, was signed into law by Governor Brian Kemp on April 4.

Passage of the bill is a positive step in the effort to stem the advance of what most observers would rightly characterize as a sweeping mental health epidemic cascading through our nation which is, by extension, negatively impacting the lives of millions of Georgians.

For far too long, mental health care has been somewhat relegated to second-tier status by many in the health care and insurance provider industries. As infrastructure, investment and innovation have broadly accelerated for "traditional medicine," mental health care has by and large received little more than lip service from most health systems and health insurers.

Thankfully, there have been exceptions to this rule as some key market leaders identified mental and behavioral health care as a priority years ago, strategically invested to enhance resources, and now have the ability to point to empirical data validating that their investments in mental health resources have resulted in observably positive mental health outcomes for patients.

Thankfully, the trailblazing work of leading-edge health systems, mental health providers and mental health advocates has to a degree turned the tide. Mental health care is now being more rightly prioritized (and destigmatized) and, as that continues to occur, meaningful positive change with respect to provider infrastructure, insurance funding and patient outcomes could likely follow.

Georgia's Mental Health Parity Act legislates, among other things, that "every health insurer that provides coverage for mental health or substance use disorders as part of a health care plan shall provide coverage for the treatment of mental health or substance use disorders in accordance with the Mental Health Parity and Addiction Equity Act of 2008."

For context, the Mental Health Parity and Addiction Equity Act is a federal law that broadly dictated that most health plans had to ensure that, if they provided coverage for mental health under their policies, the benefits of their coverage for mental health care must be, at minimum, at a point of parity with the coverage levels for non-mental health needs. For example, if a health insurance policy includes access to an unlimited number of primary care physician visits for "physical health care" the policy could not impose a visit limitation on mental health care provider visits.

Most employers sponsoring group health plans will find that their policies already comply with the MHPAEA and, as a result, the majority of group health plans will already find themselves to be compliant with Georgia's Mental Health Parity Act. However, since MHPAEA did not apply to a subset of health insurance plans, including some self-funded small group plans, grandfathered large group plans, etc., the Mental Health Parity Act makes a blanket requirement for coverage parity across the board. Importantly, the Mental Health Parity Act will not apply to employee benefit plans sitused in another state; however, all health insurers with plans sitused in the State of Georgia will now be compelled to make necessary adjustments to their policy language to ensure compliance.

As a practical matter, now that coverage parity is mandated as outlined above, the next focus will need to be on increasing the number of mental health providers, strengthening provider networks such that insureds find their preferred providers to be "in-network" and continuing to invest in innovative solutions to improve the scalability and efficacy of mental health care.

Thankfully, the Mental Health Parity Act goes beyond just mandating health insurance coverage parity by also including other key provisions which will, among other things, allocate funds and incentives to try to increase the number of psychiatric practitioners in the State, create a Behavioral Health Care Workforce Database, establish a grant program to assist outpatient treatment programs, improve transparency, reauthorize the Behavioral Health and Innovation Commission and more.

There is no question that solving the mental health crisis will require much more than one bill. However, thanks to the collaboration and focus across party lines on this key issue facing the State of Georgia, our legislators are to be commended for their efforts. And we all stand in hopeful expectation that mental and behavioral health resources will continue to grow and, as a result, patient outcomes will continue to improve.