September 6, 2018

A Strong, New Mental Health Parity Law

In Illinois, mental health and physcial health are equalBehavioral health coverage loopholes: Closed! SB 1707, a bipartisan mental health parity bill, is now the law of the state.

The bill, signed by Gov. Rauner on August 22, now Public Act 100-1023, strengthens the existing state parity law and arms the Department of Insurance with clear enforcement powers.

Calling it “the strongest mental health parity law in the nation,” the Kennedy Forum noted that introduction was spurred by a provider survey undertaken by the forum and its partners. The survey documented frequent denials for mental health and addiction treatment, particularly “for inpatient mental health and addiction treatment, where nearly 60% of responding providers reported that MCOs often or always denied coverage.“ The group, focused on policy in the behavioral health field, spearheaded the push for passage.

The federal Mental Health Parity and Addiction Equity Act already requires health plans to cover mental health and addiction care the same way they cover physical health benefits. Although the federal law has been in effect for 10 years, insurers have often denied payment based on the need for pre-authorization or seen as not medically necessary.

“Complying with state and federal mental health parity laws only happens when insurers are held accountable,” said Rep. Lou Lang, the chief sponsor of the act.

The measure takes a multi-pronged approach, expanding access to addiction treatment, increasing health plan transparency, and improving parity enforcement. It requires insurers to submit parity compliance analyses to the to the state. It also prohibits prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders, and requires these medications to be on lowest-tier of prescription formularies.

“By prohibiting prior authorization and other administrative barriers, individuals will get the right care and get the care when they need it,” said Sara Moscato Howe, CEO of the and the Illinois Association for Behavioral Health, which was part of a coalition supporting the bill.

In its path to enactment, SB 1707 had strong support, passing 106-9 in the House and 52-0 in the Senate and was enacted as part of an Illinois GOP response to the opioid crisis. It was one of a package of five bills signed by governor, which also include a measure to remove preauthorization requirements for the first 180 days of medically necessary mental health and subtance use treatment ( SB 682 ) and to expand access to behavioral and mental health treatment for Medicaid beneficiaries by adding coverage for telehealth ( SB 3049 ). The package also included a diversion bill ( SB 3023 ) that has been called groundbreaking in authorizing local programs that direct persons with substance use problems into addiction treatment services.

Parity has been increasingly seen as an important issue of healthcare access. This summer, even prior to the bill’s passage, the Department of Insurance has also been holding events across the state to inform residents of their mental health parity rights and how to use them.

The law takes effect January 1, 2019.

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