Health insurers should be frequently audited by the federal government to guarantee that plans follow mental health parity laws; just one of the recommendations of a White House task force that’s taking aim as the nation’s burgeoning drug addiction crisis. Physicians need not obtain prior approval for drugs such as buprenorphine, which is used to treat drug addiction, just as prior approval is not needed for many drugs for physical illnesses, the New York Times reports. The task force warned insurers against restrictions on mental health services that are not in place for other services. Of course, restrictions may be difficult to avoid inasmuch as the task force did cite significant shortages of clinical social workers, psychiatrists, and others who can provide addition treatment.
America’s Health Insurance Plans said it favors the effort, with the group’s senior vice president, Kate Berry, telling the Times that the task force’s report contained a “a lot of good recommendations to help consumers understand what parity means.” She added that health plans are “working very hard to comply and have made significant progress.”
Insurers may find themselves in situations where even actions that do not violate the law will need to be explained, according to the Times. “If, for example, a health plan requires prior approval, or preauthorization, for all mental health care services or all addiction treatments, the government may investigate. Likewise, federal officials said they could investigate if an insurer required a psychiatrist to file a treatment plan or a progress report on a patient every 30 days, or paid only for mental health treatments that produced a ‘measurable and substantial improvement’ within 90 days.”
Souce: New York Times