Before the Mental Health Parity and Addiction Equity Act (MHPAEA) went into effect in 2010, many plans covered only a specific number of behavioral health treatment days or visits; post-MHPAEA, such QTLs were allowed only if they were “at parity” with medical-surgical limits. A study of claims processed by Optum, a large managed behavioral health organization, found significant differences after the law went into effect, reported Amber Thalmayer, Ph.D., and colleagues. At the time of the study, Thalmayer was affiliated with Optum; she is now at the Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
Between 66 percent and 90 percent of plans in 2008-2009 had annual limits on inpatient or outpatient services, with medians of 30 days and 45 visits, said Thalmayer and colleagues. By 2011, fewer than 1 percent of carveout plans and 3 percent of carve-in plans still had limits on those services.
The researchers speculated that the potential administrative burden of matching mental health coverage with other types of medical/surgical coverage made it simpler to eliminate the treatment limits.
Perhaps most important was the benefit to patients, wrote the researchers. “One of the most meaningful impacts of MHPAEA is improved insurance protection for needed specialty behavioral health care for children and adults with depression, bipolar disorder, or psychosis, who were most likely to reach their inpatient and outpatient limit thresholds preparity.”
The researchers also pointed out, however, that increasing access to behavioral health care means going beyond QTL changes and looking at other areas of benefit management.
For more in Psychiatric News about mental health parity, see “White House Task Force Issues Report to Improve Parity Compliance.”