Rep. Andersson questions mental health parity compliance by state's Insurance Department
Rep. Steve Andersson (R-Geneva) recently questioned mental health professionals at length on the parity between psychological welfare and drug addiction.
At a House Mental Health Committee hearing on Dec. 18, Andersson wanted to know exactly what more the Illinois Department of Insurance (DOI) could be doing to address the recent concerns revealed in the Kennedy Forum “Illinois Health Plans Frequently Deny Coverage of Mental Health Addiction,” survey.
“It says the DOI is supposed to proactively monitor discriminatory practices,” Andersson said of the DOI compliance with Medicaid Managed Care organizations (MCOs) and commercial insurance plans regarding mental health and drug addiction parity.
Andersson could not question a DOI official directly since no one from the division showed up for the hearing, which is why Kennedy Forum Illinois Director of Public Policy David Lloyd, who appeared before the panel, answered.
“I think there is resistance, and I think the department will explain it is a resource allocation issue, but we think at the very least they need to be requesting the analysis that plans are already required to do under federal law,” Lloyd said. “That is a good place to start along with working with us. We can help them on how they best target their resources on parity.”
According to Tim Clement, senior policy adviser for The Kennedy Forum, DOI has been given up to $1.4 million in funds through the Centers for Medicaid and Medicare Services to comply with federal mental health parity and drug addiction laws.
The Mental Health Parity and Addiction Act essentially mandates that group health plans and health insurance issuers recognize mental health conditions and substance use as equal to physical illnesses.
“Have they taken the position that they are complying with this proactive requirement of monitoring discriminatory practices,” Andersson asked.
“I think they would say yes, but I disagree,” Lloyd said, adding the DOI has responsibilities under state law to conduct form reviews before they certify treatment plans. “That is one place that we encourage them to actually request the analysis directly from the insurers, so they can verify that plans are in compliance and they also have market conduct examinations that they should be doing on a regular basis.”
Andersson questioned if the DOI "resource argument burden" was based on either attaining or analyzing data The Kennedy Forum provides.
“We think they have resources under this federal grant,” Lloyd said. “We think they should be doing target reviews that will help show them where potential problems are, and they can do deep dives there.”
Andersson said since the DOI apparently believes they are complying with the law, he offered assistance from legislators to amend HB68, which deals with the state insurance code, to be more specific so The Kennedy Forum could further help Illinois comply correctly with mental health parity and drug addiction.
“In this field, fail first can often mean suicide,” Andersson said.