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Do we really have ‘mental health parity’ under ERISA?

December 14 marked two-year anniversary of the Sandy Hook massacre in which 20 first grade students and six teachers were gunned a young mentally disturbed man. The television show “60 Minutes” took the opportunity to air a segment that night on the problem of insurance companies denying mental health care. The segment, called “Denied” discussed the tragedies that result when mentally ill people who are a danger to themselves and others are denied adequate coverage for their care by their insurers. Reportedly, the Sandy Hook killer’s parents had sought treatment for their son, but their insurance company refused to cover it.

The Mental Health Parity and Addiction Equity Act of 2008 was passed as an amendment to earlier legislation, including the Employee Retirement Income Security Act. The MHPAEA requires employers with more than 50 people as well as the health insurance issuers who sell these plans to ensure that benefits, financial requirements and treatment limitations are no more restrictive than those for medical and surgical benefits. Treatment limitations, according to the U.S. Department of Labor, cover the scope, duration and frequency of treatment.

The law passed with bipartisan support in Congress. Former Congressman Patrick Kennedy, a sponsor of the bill and an outspoken mental health advocate, addressed the “60 Minutes” piece the following day, saying that the purpose of the law was, “in part, intended to ensure that no individual, no family — no American — had to endure what we saw outlined on ‘60 Minutes.'” He noted, “At best, we’re seeing inconsistent compliance with the law” and that more than one insurance company is to blame.

People who are denied claims for mental health treatment for themselves or loved ones can and should seek legal guidance from an experienced disability rights attorney to determine what options they have. If insurance companies are not held accountable for providing appropriate mental health coverage, there could be many more tragedies like Sandy Hook in our future.

Source: United States Department of Labor, “Fact Sheet – The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)” Dec. 18, 2014

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