On Wed., Feb. 12, OPPA President-Elect, Megan Testa, MD, spoke in support of Senate Bill 254, the Mental Health Parity and Addiction Equity Act. This bill would align Ohio’s mental health parity laws with current federal law; raise awareness amongst individuals, families, and employers about their rights and responsibilities under the law; and facilitate greater implementation and enforcement to ensure that health plans are complying with parity laws.
In her testimony, Dr. Testa stated: "There are several fixable problems that currently exist in Ohio regarding insurance coverage for people with mental illness and substance use disorders. Current public mental health crises demand that the state fix these problems to bring our state law into compliance with the Federal Parity Act. Full parity between mental health and substance use disorder benefits and other medical benefits is a vital tool in protecting vulnerable Ohioans, stemming the tide of these crises, and controlling the health care costs created by untreated mental illness and substance use disorders."
Dr. Testa went on to say: "the Federal Parity Act requires that insurance plans offer the same level of treatment to the mental health diagnoses that they cover as they do to physical health diagnoses that they cover, we still see many areas in which patients with mental illness and substance use disorders face insurance limitations that people with physical health diagnoses do not. An important example of this is the practice of quantitative limits on physician office visits and hospital stays. The plans that many patients have in Ohio, even when they have chosen plans specifically because they afford mental health benefits, have arbitrary rules stating how many physician visits they will cover for treatment of a mental health condition. Because of this, an outpatient physician who sees a patient frequently because of illness exacerbation may be denied payment for a claim and told that they have already seen the patient for the allowable number of times that year. An inpatient physician who is treating a patient who was doing poorly enough to be hospitalized for their mental illness may be denied payment for hospital days subsequent to an arbitrary cut off number."
Further, Dr. Testa stated: "What this all means is that purchasers of medical insurance in Ohio that offer benefits for mental health and substance use disorder are paying for benefits they are not able to receive. Too many working Ohioans who have health insurance benefits for mental health and substance use disorder for either themselves or a loved one, are basically throwing their money away (as are employers) because services that they need and believe are covered are denied by the health plans, or because of lack of access to physicians who treat mental illness and substance use disorders due to lack of participation in health plan networks."
Read Dr. Testa's full testimony