HHS to issue sweeping mental health rules

The Obama administration will issue long awaited regulations Friday that require insurers to treat mental illness and addiction the same as physical illnesses, current and former lawmakers said.

In testimony Thursday before a Senate Judiciary subcommittee, mental health advocate and former Rep. Patrick Kennedy (D-R.I.) said Health and Human Services Secretary Kathleen Sebelius would announce the action during a speech in Atlanta. Members of the panel familiar with the rule-making also said the regulations would be issued Friday.

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Kennedy, during his 16-year tenure in Congress, championed legislation designed to bring insurance parity to people suffering from addiction and mental illness. The Mental Health Parity and Addiction Equality Act was enacted in 2008, but key regulations are not yet in place.

“Naively, it turns out, we believed we had done the heavy lifting and thought the regulatory process would simply operationalize the solution we had achieved,” Kennedy said. “In truth, the Mental Health Parity and Addiction Equality Act instead entered a kind of twilight zone in which everyone with an interest in it was left to imagine what it meant.”

The result, lawmakers and witnesses at the hearing said, has been a lengthy period of uncertainty for insurers and gaps in coverage form mental illness sufferers that were meant to be closed with enactment of the 2008 law. 

“Five years after the act was passed, this promise remains unfulfilled,” said Sen. Richard Blumenthal (D-Conn.), chairman of the Judiciary subcommittee on Oversight, Federal Rights and Agency Action.

“The costs have been tremendous,” Blumenthal said. “In mental health, uncertainty kills.”

Kennedy, who has himself struggled with addiction and mental illness, said the new rules are urgently needed to ensure that soldiers returning from overseas with traumatic brain injuries and post-traumatic stress issues have access to treatment.

Kennedy said he remains concerned about the implementation of the regulations, which are the product of rule-making efforts at the Treasury and Labor departments, as well as the HHS.

In particular, he said the agencies must demand public disclosure of the system used by insurers to make coverage decisions. He said the law’s architects intended the adoption of regulations that ensure people with “invisible” mental diseases have treatment equivalent to those suffering from physical ailments.
 
“We were crystal clear about what we meant,” he said. “The services must be the same.”