The Obama administration "is stepping up enforcement of laws that require equal insurance coverage for mental and physical illnesses, a move officials say will help combat an opioid overdose epidemic," Robert Pear reports for The New York Times. Opioid rates have been on the rise nationwide, especially in many rural areas. Obama in July called on Congress to approve $1.1 billion in new funding to make opioid treatment available for every American.
"A White House task force on Oct. 27 said insurers needed to understand that coverage for the treatment of drug addiction must be comparable to that for other conditions like depression, schizophrenia, cancer and heart disease," Pear writes. "As an example, the administration said, insurers may not require prior approval for drugs to treat opioid addiction, like buprenorphine, if they do not impose similar restrictions on drugs with similar safety risks that are prescribed for physical illnesses."
The task force "called for more frequent audits of health plans and warned insurers against imposing stricter requirements on mental health services than on other types of medical care," Pear writes. "More than 40 million people—about one in five American adults—experience some kind of mental illness each year, the administration said, and more than 20 million have a 'substance use disorder' involving drugs or alcohol."
Over the past five years the U.S. Department of Labor has conducted 1,515 investigations of possible parity violations, issuing 171 citations for noncompliance by employer-sponsored health plans, Pear writes. "Those 171 citations are more significant than the number might appear, said Phyllis C. Borzi, an assistant secretary of labor. When the government finds violations, she said, it requires insurers to correct all their health plans, so that a single citation may produce 'global changes' affecting tens of thousands of group health plans with millions of participants." (Read more)
"A White House task force on Oct. 27 said insurers needed to understand that coverage for the treatment of drug addiction must be comparable to that for other conditions like depression, schizophrenia, cancer and heart disease," Pear writes. "As an example, the administration said, insurers may not require prior approval for drugs to treat opioid addiction, like buprenorphine, if they do not impose similar restrictions on drugs with similar safety risks that are prescribed for physical illnesses."
The task force "called for more frequent audits of health plans and warned insurers against imposing stricter requirements on mental health services than on other types of medical care," Pear writes. "More than 40 million people—about one in five American adults—experience some kind of mental illness each year, the administration said, and more than 20 million have a 'substance use disorder' involving drugs or alcohol."
Over the past five years the U.S. Department of Labor has conducted 1,515 investigations of possible parity violations, issuing 171 citations for noncompliance by employer-sponsored health plans, Pear writes. "Those 171 citations are more significant than the number might appear, said Phyllis C. Borzi, an assistant secretary of labor. When the government finds violations, she said, it requires insurers to correct all their health plans, so that a single citation may produce 'global changes' affecting tens of thousands of group health plans with millions of participants." (Read more)
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