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An Invitation to ME-P Readers on the Implications of Implementation
By Karen D. Matthias RN, MBA
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was enacted into law on October 8, 2008. This act will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. The regulations that guide implementation of this law will be effective for health plan years beginning on or after July 1, 2010. These regulations have significant implications for providers of mental health services, payers, employers, and consumers.
Hayes, Inc
On June 23rd and 24th, Hayes, Inc. and URAC are hosting a 2-day symposium in Baltimore featuring an expert faculty of nationally known legal experts, researchers and leaders brought together to provide detailed information about this law and its expected impact on all stakeholder groups www.urac.org/2010MHPConference
David Wellstone (Dave) will be giving the keynote address. Mr. Wellstone is the son of the late Senator Paul Wellstone (D-MN, 1990-2002). Along with his brother Mark, Dave is the Co-Founder of Wellstone Action, a national center for training and leadership development for the progressive movement. Dave is the Co-Chair of the Wellstone Action Advisory Board and contributes to advocacy efforts on behalf of mental health and domestic violence.
Speaking
Also speaking is Carol McDaid, co-founder and Principal of Capitol Decisions Inc. Ms. McDaid led the Parity NOW Coalition behind passage of the 2008 “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.” Ms. McDaid has nearly 25 years of federal legislative experience in Washington, providing her clients with legislative and public affairs consulting on issues that span the breadth of health care, including Medicare, Medicaid, private sector reimbursement issues, and comparative effectiveness research.
Assessment
Both Dave Wellstone and Carol McDaid are available to answer your questions about the implications of implementing this legislation. If you, or any of your ME-P colleagues or readers are interested in interviewing either Dave or Carol (or both), please contact me at 215-855-0615 or via email at kmatthias@hayesinc.com
Thanks for your consideration.
Hayes, Inc
157 S. Broad Street
Lansdale, PA 19446
T: 215-855-0615 x7918
Email: kmatthias@hayesinc.com
Website: www.hayesinc.com
Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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Filed under: Alerts Sign-Up, Career Development, Health Law & Policy | Tagged: Capitol Decisions Inc, Carol McDaid, David Wellstone, domestic violence., Hayes Inc, mental health, mental health policy, Pete Domenici, Senator Paul Wellstone, URAC, Wellstone Action Advisory Board, Wellstone-Domenici Mental Health Parity and Addiction Act |
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MHPAEA
While it is true that on July 1st, the Mental Health Parity and Addiction Equity Act (MHPAEA) goes into effect, actuarial tests show that most employer-sponsored health plans will not be able to meet its parity requirements,
http://www.lifeandhealthinsurancenews.com/News/2010/6/Pages/Most-Health-Plans-Dont-Have-Mental-Parity-Expert.aspx
Hope
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Mental e-Health
Mental health advocates continue to press for psychologists, licensed clinical social workers, substance abuse professionals, psychiatric hospitals and related providers to be included in the federal eMR incentive program.
http://healthitupdate.nextgov.com/2010/07/mental_health_advocates_are_seeking.php
Joan
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House Subcommittee Votes to Repeal IPAB
Members of the House Energy and Commerce Health Subcommittee approved a bill to repeal the Independent Payment Advisory Board (IPAB) created in the health reform law. In a 17-5 vote, the panel supported the Medicare Decisions Accountability Act of 2011, a bill introduced last year by Rep. Phil Roe (R-TN), a physician. Roe’s bill now has 226 co-sponsors, including 17 Democrats.
The House Ways and Means Health Subcommittee will have a hearing to examine IPAB next week. Following the subcommittee vote, Rep. Joe Pitts (R-PA), chairman of the Health Subcommittee, said he did not know for sure when the bill would make it to the full House floor, but that “I’d expect (it will) by the end of March.”
Source: Jessica Zigmond, Modern Healthcare [2/29/12]
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Percentage of Those Who Get Stress or Behavior Management Support From a Health Care Provider That Reported Doing an Excellent or Very Good Job
A Great Deal/A lot of Support Little/No Support
Having a good relationship with my family 71% 50%
Having good relationships with my friends 63% 39%
Doing well in my career/studies 61% 39%
Managing stress 47% 29%
Eating healthy 47% 29%
Getting enough sleep 44% 25%
Being physically active or fit 40% 28%
Publication Source: Employee Benefit News, April 15, 2013
Data Source: American Psychological Association
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Autism Will Cost the U.S. $461 billion by 2025
UC Davis recently released economic projections for Autism Spectrum Disorder (ASD) in the U.S. Here are some key findings from the analysis:
• ASD-related medical, nonmedical and productivity losses are estimated at $268 billion for 2015.
• Costs of ASD will range from $276 to $1 trillion (with a best estimate of $461 billion) for 2025.
• The current costs of ASD are more than double the combined costs of stroke and hypertension.
• If ASD prevalence continues its current growth trend, the costs will exceed those of diabetes by 2025.
• Diabetes is funded by the National Institutes of Health at over than five times the level of research on ASD.
Source: UC Davis, July 28, 2015
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Medicaid plans can now pay mental health institutions. Most won’t until 2017
◾ A fifty-year ban on state Medicaid payment for mental health institutions was just lifted.
◾ The Center for Medicare and Medicaid Services (CMS) estimates that 7.1% of adults between the ages of 21 and 64 meet the criteria for serious mental health illness requiring inpatient treatment.
◾ Since Medicaid’s creation in 1965, it has excluded payment for institutions of mental disease (IMDs) for Medicaid beneficiaries ages 21+.
◾ This exclusion has meant negative care experiences for Medicaid beneficiaries suffering from mental illness, as they often have long stays in emergency departments and may be referred to stand-alone psychiatric facilities that have little incentive to provide quality care.
◾ Still, Director of Legislative Affairs for National Alliance on Mental Illness (NAMI), Andrew Sperling, stated that no major changes would occur immediately, as plans needed time to contract with facilities and for these contracts to commence.
Kim Reimold (@kimreimold)
Anthony Moccia (@anthony_moccia)
Raj Pammal (@rspammal)
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