Pete Abel lands the exclusive and discusses the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act Of 2008.

The following passage highlights one of the most important parts of the legislation because it shows how genuine policy compromise got this passed…

TMV: As I understand it, the current bill is not a mandate to offer mental health benefits. Instead, it’s a mandate that, if an insurance company already offers mental health benefits, it must then offer them at parity with physical health benefits. Are you at all concerned that this requirement might discourage insurance companies from offering any mental health benefits?

RPK: No. If we had mandated coverage of (the entire diagnostic manual), this bill would not have become law. Part of our compromise was to let employers and insurance companies determine what they would cover, with medical necessity as the determinant of the day, not arbitrary selectivity.

Our fall back position is that we want the GAO to study the patterns of mental health coverage going forward … to see how widely mental health diseases are being covered. If the GAO determines those diseases are insufficiently covered, we’ll have to come back and shore up the law.

Also, we have very strong language in the law defining “medical necessity” and how to determine a patient’s eligibility for mental health coverage, so that when people sign up for coverage, they know what the grounds are for denying coverage, strengthening their ability to appeal arbitrary decisions.

Check out the whole thing here.

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