While we have been working on the Medicaid system, and on finishing off the Omnibus Mental Health Bill, the Department of Mental Health has been trying to clarify what the new Mental Health Parity Laws mean in real life. They issued one memorandum to the commercial insurers in March, in which they clarified who was covered; they need to issue a memorandum discussing what sort of services should be covered under the parity law.
The big sticking point is the level of intermediate services that are covered. Both Medicaid and the Private payers cover the easy stuff: When I want once a week meetings with a therapist for a child with mild mental illness, I can get that through the outpatient department. When I want hospitalization, I can get it if I jump through enough medical necessity hoops. What about all of the other services that we can get for children on Medicaid (but not on the privates), like the ICC, the Home-based behavioral and psychotherapy sessions, the Parent Partners and the like? I once had an insurance company (or rather a nice person at an insurance company) tell me that they would rather pay for the EMH and Hospitalization than cover in-home therapy for a kid who was making weekly trips to the psych ER. Wouldn't budge, even though it would save them money. So, doesn't it make sense that Mental Health Parity means that the private sector should cover the same services as are covered by Massachusetts Medicaid program?
That is the message that we in the Children's Mental Health Campaign want to send to the Division of Insurance and the Department of Mental Health: parity means more that covering hospitalization. Private insurance should cover a WIDE RANGE of Intermediate Services, including :
- Intensive Care Coordination
- Community Based Acute Treatment
- Family Consultation
- Day Treatment
- Crisis Stabilization
- Family Stabilization
and many other things. Basically, private insurance should cover everything that the public sector is providing under the CBHI. Intermediate Care is the key to creating a mental health system that actually achieve parity with the physical health system.