U.S. Representative Joe Kennedy III (D-Mass.) this week introduced the Behavioral Health Coverage Transparency Act of 2015, which he says will hold health insurers more accountable for parity and require them to disclose with greater transparency the rationale behind coverage denials.
The proposal would require insurers to disclose annually to federal regulators the process they use in making parity determinations as well as the frequency and reasons for mental health claims denials versus medical/surgical denials. According to the National Alliance on Mental Illness, insurers deny authorizations for coverage of mental health services at nearly twice the rate as medical care.
Three federal departments would conduct a minimum of 12 random audits of health plans per year to discourage noncompliance with existing parity laws under Kennedy’s proposal. Finally, it would establish a Patient Parity Portal, allowing consumers to access all publicly available parity information and submit complaints online.
“Too many Americans suffering from mental illness are unable to access the treatment they need because their insurance company refuses to cover it – oftentimes with no explanation at all ,” said Kennedy in a statement.
Kennedy is former Congressman Patrick Kennedy’s cousin. Patrick created the Kennedy Forum, a mental health advocacy group with a focus on parity, in 2014.
The legislation has received support from the following advocacy and expert organizations: American Foundation for Suicide Prevention/SPAN USA, American Psychiatric Association, American Psychological Association, Bazelon, Eating Disorders Coalition, Kennedy Forum, Legal Action Center, National Alliance to Advance Adolescent Health, NAMI, National Association for Children's Behavioral Health, National Disability Rights Network, Massachusetts Medical Society, Parity Implementation Coalition.