- Seven years after a federal law was signed banning discrimination in the treatment of mentally ill people, mental health advocates say the issues it was designed to address still persist.
- Although insurers have ended annual limits on therapy visits, some use other methods that essentially have the same effect, according to Kaiser Health News.
- At the heart of the controversy is the use of medical necessity reviews, which insurers use to decide whether patients should receive certain treatments.
"'Medical necessity' is the insurers' last hurrah," said Meiram Bendat, an attorney for the father of a 20-year-old bipolar son whose covered visits to a psychiatrist were cut back by a medical necessity review. The son relapsed and the father sued, claiming the treatment was held to a more strict standard than patients with physical ailments.
Former Magellan Health CEO Henry Harbin told Kaiser that insurers "can micromanage care down to almost nothing," and said enforcement in the law was "a joke."
But insurers face their own challenges. “A treatment plan for diabetes or a chronic heart disease is very different from a treatment plan for a patient that’s seeking care for depression or another mental illness,” Clare Krusing, a spokesman for America's Health Insurance Plans, told Kaiser.