Obama Administration issues rules requiring parity in treatment of mental, substance use disorders

[kpete]

Source: PR Newswire

Obama Administration issues rules requiring parity in treatment of mental, substance use disorders

Paul Wellstone, Pete Domenici Parity Act prohibits discrimination

WASHINGTON, Jan. 29 /PRNewswire-USNewswire/ -- The U.S. Departments of Labor, Health and Human Services (HHS), and the Treasury today jointly issued new rules providing parity for consumers enrolled in group health plans who need treatment for mental health or substance use disorders.

"Today's rules will bring needed relief to families faced with meeting the cost of obtaining mental health and substance abuse services," said U.S. Secretary of Labor Hilda L. Solis. "The benefits will give these Americans access to greatly needed medical treatment, which will better allow them to participate fully in society. That is not just sound policy, it's the right thing to do."

"The rules we are issuing today will, for the first time, help assure that those diagnosed with these debilitating and sometimes life-threatening disorders will not suffer needless or arbitrary limits on their care," said Secretary of Health and Human Services Kathleen Sebelius. "I applaud the longstanding and bipartisan effort that made these important new protections possible."

"Workers covered by group health plans who need mental health and substance abuse care deserve fair treatment," said Deputy Treasury Secretary Neal Wolin. "These rules expand on existing protections to ensure that people don't face unnecessary barriers to the treatment they need."

Read more: http://www.prnewswire.com/news-releases/obama-administration-issues-rules-requiring-parity-in-treatment-of-mental-substance-use-disorders-83038302.html

[EFerrari]

1. I don't get it. I thought the Wellstone Act already did that?

[shraby]

3. Maybe it was supposed to, but I know the policy we had

before retirement had a limit on the number of days for treatment for mental problems.

[EFerrari]

4. Doug had Blue Cross and they used to throw him out of the hospital

whether he was stable or not and that only ensured that he'd be back more often than not.

But, is the administration saying they are making sure the Act is enforced? Maybe I'm just stupid today. lol

[boppers]

6. Wellstone act was the legal framework.

These are the rules for compliance within that framework.

[postulater]

2. I hope it doesn't just turn into another cash cow for Pharma. nt

[Betsy Ross]

5. Probably won't apply to Medicare.

Many disabled by mental illness get Medicare but they won't pay for prescribing psychiatrist.

[EFerrari]

7. But that should be against the law now.

:wtf:

[Posteritatis]

15. Definitely, but haven't a few states actually gone far enough to turf mental health coverage lately?

I seem to recall California trying to push the idea that mental illness is just a moral failing and not an actual problem and therefore shouldn't be covered under state benefits, for instance. I imagine several other states have similarly, ah, enlightened views.

[elocs]

8. My goddaughter who turned 18 last year was diagnosed with schizophrenia.

Last year was a terrible year for her and she was hospitalized 13 times at 7 different hospitals in the Chicago area. In June her mother was informed by registered letter from her insurance company that she had used up her mental health benefits for the year. She used up her ration for 2010 with no more coverage until this year, and her mother works for one of the major hospitals in Chicago but her insurance would not provide for coverage there. The 6 months of no coverage nearly resulted in bankruptcy for her mother as she had to cover all the expenses of the hospitalizations and medications.

My goddaughter is now in a group home and her school district will be paying to see that she gets the high school education she missed out on until she is 22. She is now on Medicaid, but the coverage is not so good so her mother's insurance is making up for some of that, but at least her coverage cannot be cut off now.

[EFerrari]

9. Someone who was hospitalized 13 times in one year

is not getting adequate care anywhere.

They used to kick my ex out, too, before he was stable and to hell with the consequences. Had they kept him a whole two weeks or so to get stable on his meds, he might have had a chance in hell of having a life.

I finally just demanded that his family front us the money for him to go to a real, good doctor and between the both of us, he was stabilized. He went five years once between decompensations because he finally had somewhat adequate care and because that's what I did 24/7. He got a life and his career back, friends, the whole tamale.

What happens to the mentally ill in this country is a crime against humanity.

[elocs]

10. The trouble is that she would act out or run away and get into trouble,

then the police would either come and get her or pick her up and take her to the psych ward, wherever they had a bed available. There they would medicate her, keep her for 2 weeks, then kick her loose and send her home to her mother and stepfather, both of whom work. Now she's home alone and although she's on medication there is no follow up as to how the medication is working since she has seen so many different doctors. So these many months later we find out that her medications were not working, she was hearing voices and getting little sleep, and on top of it all she was drinking.

Over and over, wash, rinse, and repeat. The day she turned 18 she entered a good group home for girls her age with her problems and others and that day she decided since she was an adult that she would not take her meds which seemed to be working well. That means within a few weeks she was crashing again and in the hospital again only this time she was in with the adults.

The breakthrough came in the fall when she looked up schizophrenia online and the light came on and she was convinced that she had it. She also realized then that she needed to be and to stay on her medications and to work with her doctors. It's then that she told us about the terrible hallucinations she was having as well as the voices she was hearing, along with the paranoia. That girl went through a year of hell, and yes the system and the insurance company and the hospitals did not serve her well, but they all lined their pockets with money for doing it.

Today she has hope and the support and backing of people who love her and even though there may be some bumps in the road, a chance for a good future. But she is also luckier in that than many who are mentally ill.

[EFerrari]

12. That poor family. But, yes, even so they are luckier than many.

I'm glad to hear that things are so much better. She may lose her insight occasionally but hopefully not for long. I have an adult cousin who went through a similar process and while he has an occasionally small meltdown, he's not starting from scratch when the episode passes.

[robcon]

11. The problem with this is that so many people seek treatment who are simply unhappy.

And the therapists are all too willing to try to "treat" unhappiness, instead of mental illness, as long as someone is paying. Unhappiness is untreatable.

The problem, of course, is that those who need help will be lumped in with those who are simply unhappy... an invitation to abuse of the system. (I don't know the solution.)

[Posteritatis]

13. The problem is that many who need treatment are dismissed as "simply unhappy." (nt)

[robcon]

16. I disagree. there is no reluctance to treat people who are clinically depressed.

But there is a larger base of people, IMO, who are not clinically depressed, but want to talk to someone about their unhappiness.

[EFerrari]

14. The problem with our so called mental health system is not that people who don't need it use it

but that the majority of people who try to use it because they do need it do not get good care delivered.