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AMBHA advocates nondiscriminatory benefit coverage in both public and private insurance; i.e., parity for mental illness and addiction disorders in benefit coverage.
Statement
Benefit plans for the treatment of mental/psychiatric and addictive disorders, in both the public and private sectors, shall be comprehensive; i.e., they shall cover the entire continuum of clinically effective and appropriate services provided by all competent licensed professionals, and should provide identical coverage and funding to those benefits covering physical illness, with the same provisions, lifetime benefits, and catastrophic coverage.
Next Steps
A national dialogue must take place among consumers, family members, professionals, managed care organizations, employers, and state and national government addressing the following critical issues:
- In an environment of global competition, increasing health care needs, an aging population, and constraints on tax revenues, can we identify best practices that demonstrate comprehensive coverage and its affordability, and how can we best encourage the adoption of these best practices in public and private benefit plans?
How can we reduce the amount of variability between states regarding the interpretation of parity legislation, increase the consistency between various state laws on this issue, and prevent legislation on federal and state levels that inhibit the adoption of the best practices we have identified?
Is it possible to achieve consensus on what it means for a service to be "medically or clinically necessary", "appropriate" or a legitimate use of a benefit plan for behavioral health problems and services? What are our alternatives to achieving and maintaining full parity at affordable costs if consensus on these definitions cannot be reached?
AMBHA further encourages expanded and focused debate and discussion on three major incremental elements associated with parity:
- The desirability of enacting catastrophic coverage protection as an incremental first step toward parity.
The desirability of including serious mental illness and serious emotional disturbance as an incremental first step toward parity.
Movement towards parity coverage of addiction disorders.
?Further Information
Pamela Greenberg, M.P.P.
Executive Director
?January 1997
Revised September 1998
AMBHA 1997 Members:
CMG Health, Inc., Owings Mills, MD; CNR Health, Inc., Milwaukee, WI; ComCare, Phoenix, AZ; Comprehensive Behavioral Care, Tampa, FL; CORPHEALTH, Fort Worth, TX; FPM Behavioral Health, Winter Park, FL; Green Spring Health Services, Columbia, MD; Human Affairs International, Salt Lake City, UT; Managed Care Washington, Seattle, WA; MCC Behavioral Care, Eden Prairie, MN; Mustard Seed, Bensalem, PA; Options Healthcare, Inc., Norfolk, VA; PacifiCare Behavioral Health, Laguna Hills, CA; PLAN 21, Houston, TX; Principal Behavioral Health Care, Inc., Rockville, MD; United Behavioral Health, Minnetonka, MN; Value Behavioral Health, Falls Church, VA; Vista Behavioral Health Plans, San Diego, CA.
AMBHA 1998 Members:
Alliance Behavioral Care, Cincinnati, OH; American Psych Systems, Bethesda, MD; AmeriChoice Behavioral Health, Philadelphia, PA; CNR Health, Inc., Milwaukee, WI; CORPHEALTH, Fort Worth, TX; FPM Behavioral Health, Winter Park, FL; Magellan Health Services, Columbia, MD; PacifiCare Behavioral Health, Van Nuys, CA; Plan 21*, Houston, TX; United Behavioral Health, San Francisco, CA; ValueOptions, Falls Church, VA.
*Inactive status during 1998 |
