Reps. Cardenas, Porter, Sen. Warren Reintroduce Behavioral Health Coverage Transparency Act
This
In February of this year, the Departments issued their first report following the implementation of these new provisions and documented significant gaps in compliance, confirming that more needs to be done to strengthen enforcement and protect consumers.
"Navigating our complicated health care system is often confusing and frustrating for people who are just looking to get help," said
"Health care - including behavioral health care - is a human right, and we must ensure that Americans don't face any additional barriers to getting the often life-saving care that they need," said
"Federal law requires that insurers cover mental health the same as physical health, yet I continue to hear from
The updated legislation, which builds on the provisions passed in the CAA, would:
* Increase transparency by requiring insurance plans and third-party administrators to submit annual reports with information on any non-quantitative treatment limitations and to disclose additional data on denial rates, reimbursement rates, and network adequacy;
* Encourage compliance by ensuring that HHS, DOL, and
* Establish a toll-free telephone number and an online Consumer Parity Portal to offer patients and providers a centralized website hosting information on patients' rights, findings from oversight efforts, and resources to ensure that health care consumers receive the protections they are guaranteed by law; and
* Support consumers by encouraging collaboration across federal agencies and with states, including by awarding grants to establish, expand, or provide support for offices of health insurance consumer assistance and health insurance ombudsman programs.
This legislation is co-sponsored by Senators Baldwin (D-Wis.), Blumenthal (D-Conn.), Booker (D-N.J.), Brown (D-
In a letter sent to
"The MHLG commends the introduction of legislation to strengthen implementation and enforcement of federal rules requiring coverage of mental health and substance use disorder treatment at parity with other health benefits.," said the letter. "Given the poor compliance of issuers and health plans in performing the comparative analyses required by law, as revealed by the federal agencies' report to
The letter continues, "[The Behavioral Health Coverage Transparency Act of 2022] will help ensure mental health and substance use disorder coverage is in compliance with parity, and treatment ultimately becomes available to those in need."
It has received support from over 50 advocacy and expert organizations, including:
"The Behavioral Health Coverage Transparency Act builds on the 2020 amendments to the parity law and requires greater accountability from health plans and insurers. January's report to
"The Behavioral Health Coverage Transparency Act addresses two essential strategies to achieve the Parity Act's promise: helping consumers understand and enforce their right to equitable substance use disorder and mental health insurance coverage and improving federal oversight of health plan parity compliance. Providing new federal funds for states to establish independent offices of consumer assistance will ensure individuals and families who encounter insurance barriers have the hands-on support they need to overcome them. Coupled with stronger federal enforcement of carrier compliance requirements and greater transparency, this bill will help address rising mental health needs and the escalating overdose crisis in communities across our nation." --
"Discriminatory practices by health insurers are preventing people from getting the life-saving care they need for substances use disorders and mental illness. By holding health plans accountable for providing equitable coverage, the Behavioral Health Coverage Transparency Act will increase access and promote health equity so everyone has the care they need, when they need it!" -
"The
"Despite passing the Mental Health Parity and Addiction Equity Act 14 years ago, we still too often see health insurers fail to provide coverage for mental health and substance use services at parity with physical health care," said
"The Parity Law has gone unenforced for years as Americans die from substance use disorder and mental health issues. We are pleased to support the Behavioral Health Coverage Transparency Act which will move toward enforcement of this critical law." -
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Original text here: https://cardenas.house.gov/media-center/press-releases/representatives-cardenas-and-porter-and-senator-warren-reintroduce-the-behavioral-health-coverage-transparency-act
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