Mental Health Parity Act

A Northern California woman's treatment for anorexia at a residential facility was medically necessary and must be covered by her healthcare plan, a federal appeals court has ruled in a case that could lead to more extensive benefits for those being treated for mental illnesses. Jeanene Harlick's policy with Blue Shield of California specifically excluded coverage for residential care, the room and board expenses she incurred while at the Castlewood Treatment Center in Missouri for 10 months beginning in April 2006.

A Northern California woman's treatment for anorexia at a residential facility was medically necessary and must be covered by her healthcare plan, a federal appeals court has ruled in a case that could lead to more extensive benefits for those being treated for mental illnesses. Jeanene Harlick's policy with Blue Shield of California specifically excluded coverage for residential care, the room and board expenses she incurred while at the Castlewood Treatment Center in Missouri for 10 months beginning in April 2006.

California regulators said Monday that insurers must provide speech, occupational and physical therapies to their autistic members but rejected pleas to require insurers to cover the cost of behavior therapy that aims to help patients live in society. At issue is so-called applied behavior analysis, a therapy that teaches patients skills such as self-feeding and stopping injurious behaviors such as head banging. The therapy can cost as much as $70,000 a year per patient.

The Mental Health Parity and Addiction Equity Act of 2008, by some estimates, could affect the health coverage of approximately 113 million Americans. Exactly how it will affect them, though, will vary widely. The purpose of the law, which went into effect in July, is to create equal coverage between medical/surgical services and mental healthcare services. The legislation requires group insurance plans to offer the same deductibles, copayments, frequency of treatments and days of outpatient services.

The Mental Health Parity and Addiction Equity Act of 2008, by some estimates, could affect the health coverage of approximately 113 million Americans. Exactly how it will affect them, though, will vary widely. The purpose of the law, which went into effect in July, is to create equal coverage between medical/surgical services and mental healthcare services. The legislation requires group insurance plans to offer the same deductibles, copayments, frequency of treatments and days of outpatient services.

A consumer group's lawsuit alleges that Health Net Inc., one of California's largest medical insurers, failed to provide public employees in the state with the mental healthcare it promised them in its explanation of coverage. The suit, filed in Los Angeles County Superior Court on Monday, says Health Net and a subsidiary applied a "more restrictive definition of medical necessity" that limited the type and amount of mental health care provided to its patients.

A major health insurance company has settled an enforcement action with state regulators over payments for special therapy for autism patients. California Insurance Commissioner Dave Jones on Tuesday announced that Blue Shield of California Life and Health Insurance Co. agreed to immediately cover the cost of applied behavior analysis therapy, which Jones described as a well-recognized and effective treatment. The settlement stems from a dispute that began last July when Jones filed an enforcement action against Blue Shield.

In any given year, more than a quarter of U.S. adults have a diagnosable mental health problem -- from depression to bipolar disorder -- yet fewer than half get any kind of treatment for it. The figures are similar for children. Many who do receive care get it through their primary-care physician rather than a mental health professional like a psychiatrist or psychologist. That's partly by choice: People prefer to talk to someone they know and trust about medical problems, and for many, there's still a stigma in seeing a "shrink.

WASHINGTON - When President Obama pledged this week to strengthen the nation's mental health system to help reduce gun violence, he also implicitly acknowledged that a gap remains in his signature effort to guarantee Americans access to healthcare. Two landmark laws - including the sweeping 2010 health law - have been enacted since 2008 to improve mental health treatment. But the Obama administration is still writing rules for both measures that will change how insurers deal with millions of Americans who suffer from mental illness and addiction.

A tactic used by insurance companies to deny expensive behavioral therapy to autistic children has been deemed illegal by a Los Angeles judge. In a preliminary ruling, Los Angeles County Superior Court Judge James C. Chalfant found that Kaiser Permanente's refusal to pay for a child's autism treatment because the provider was not licensed by the state runs counter to California's Mental Health Parity Act. That act requires insurers to cover care...

California regulators said Monday that insurers must provide speech, occupational and physical therapies to their autistic members but rejected pleas to require insurers to cover the cost of behavior therapy that aims to help patients live in society. At issue is so-called applied behavior analysis, a therapy that teaches patients skills such as self-feeding and stopping injurious behaviors such as head banging. The therapy can cost as much as $70,000 a year per patient.

State regulators are violating mental health and other laws by allowing health insurers to deny effective treatment for children with autism, consumer advocates contend. In a lawsuit, Consumer Watchdog, a Santa Monica group that monitors insurance practices, is asking a judge to order the Department of Managed Health Care to require insurers to provide autistic members with the services their physicians have ordered.

Mental health coverage has been the weak link in the health insurance system. Employers and insurance companies, always worried about controlling costs, often have been skeptical of the efficacy of treatments for mental health problems. Add to that the stigma and sometimes the self-inflicted shame faced by patients and their families struggling with mental illness. The result is a daunting challenge for people seeking help.