House Passes Behavioral Health Parity Bill That Could Penalize Insurers

Insurers that are not compliant with behavioral health parity rules could soon face new penalties.

Yesterday The U.S House of Representatives passed a new mental health act, that would impose fines on health plans that do not meet parity regulations and make it easier to sue insurers over behavioral health denial claims.

The legislation passed in a 220-205 vote and could help bring new clarity around mental health parity in the future. The majority of supporters were Democrats, whereas all of the lawmakers who opposed the bill were Republican..

Advertisement

Dubbed the Mental Health Matters Act, the legislation if enacted would give the U.S. Department of Labor the authority to enforce provisions from the Mental Health Parity and Addiction Act of 2008. It also seeks to ban forced arbitration agreements, making it easier to bring litigation against an insurer.   

“Plan sponsors are committed to fulfilling their responsibilities as [Employee Retirement Income Security Act] fiduciaries, which includes making recompense to individuals who were wrongly denied behavioral health benefits,” James Gelfand, president of ERISA Industry Committee (ERIC), wrote in a letter to congress. “The bill includes provisions that weaponize the Department of Labor (DOL) to sue employers rather than helping them come into compliance.”

In addition to adding parity regulations, the bill includes a slew of school-based mental health provisions. With an eye on building out the mental health workforce, the bill directs the Department of Education (DOE) to award grants designed to grow the pool of in-school mental health providers.

Advertisement

Additionally, under the bill the DOE would award grants to state agencies for recruitment and retention of school-based mental health providers. It also contains provisions for expanding student access to trauma programs and mental health services.

The legislation calls for higher education institutions to allow greater access to — and produce transparent policies around — accommodations for students with disabilities.

The Biden Administration has pledged support for the bill, which now goes to the Senate, despite backlash from payer organizations.

“[It] will strengthen the provision of affordable mental and other health care by authorizing critical tools and resources for the Secretary of Labor to enforce provisions of the Employee Retirement Income Security Act, including those added by the Mental Health Parity and Addiction Equity Act of 2008,” The White House said in a statement. “And it will help prevent Americans from being improperly denied mental health and substance use benefits by ensuring a fair standard of review by the courts and banning so-called forced arbitration agreements.”

Parity is a hot button topic in the mental health industry, as evidenced by recent activity in federal courts.

Particularly, in Wit v. United Behavioral Health, which some stakeholders have called a “landmark” case, plaintiffs allege that United Behavioral Health ignored generally accepted clinical standards when it developed rules for determining the necessity of behavioral health services. The cas has been bouncing around federal courts for nearly a decade.

Earlier this month the The U.S. Department of Health and Human Services (HHS) rolled out a new road map to improve behavioral health parity, including strengthening system capacity, connecting more people to behavioral health care, and building health environments to promote mental well-being.

Companies featured in this article: