Eight years after Connecticut passed a law to improve access to mental health insurance, the state has released its first report on the degree to which those policies are used.
In October, the Connecticut Department of Insurance issued an analysis of mental health insurance utilization for members of Connecticut health maintenance organizations (HMOs).
Based on the number of requests received for mental and behavioral health coverage ”“ and the relatively few cases any denials are overturned ”“ Health Net appears to have the most member-friendly mental health coverage of the six HMOs operating in Connecticut.
Health Net, a Los Angeles company that has its main Connecticut office in Shelton, processed 33,700 requests for coverage for behavioral health issues in 2006, along with another 12,200 requests for extensions of stay.
Oxford Health Plans L.L.C., a Trumbull company that has the largest network of physicians in Fairfield County, received just 500 requests for behavioral-health services last year.
Connecticut Healthcare Advocate Kevin Lembo said the initial statistics generated may be misleading, given the sometimes subjective nature of mental health treatment, which can feature multiple “reasonable” diagnostic approaches.
“When we see glossy numbers on the mental health front, it doesn”™t necessarily sync with what we are seeing on the ground,” Lembo said.
Beginning in 2000, Connecticut has required health plans that offer coverage for medical conditions to offer similar coverage for the treatment of mental or nervous conditions, and cannot charge more for the latter coverage.
In its most recent state-by-state study of mental health care in 2004, the U.S. Centers for Disease Control found that Connecticut had the second highest number of marriage and family counselors in the nation, as calculated as a percentage of the population.
This past September, the Wethersfield nonprofit Mental Health Association of Connecticut Inc. aired plans to create a Statewide Mental Health and Aging Coalition to improve access to mental health services for seniors.
“The Connecticut state mandate is pretty progressive,” said Eric George, associate counsel with the Connecticut Business and Industry Association. “I will say this ”“ we have got to look at the costs of our state mandates. I”™m not going to tell you one mandate is more or less beneficial than another. I will tell you Connecticut has never done an analysis of its mandates.”
Under existing mandates, if you are a fidgety coffee freak, you are out of luck ”“ caffeine-related disorders are exempted from the law, as well as a number of more common mental problems such as:
Ӣ mental retardation;
Ӣ learning disorders;
Ӣ motor-skills disorders;
Ӣ communication disorders; and
Ӣ relational problems.
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A 1996 federal mental-health law prevented insurers from not making annual or lifetime limits on care any stricter than those they offered for other medical care.
In September, the U.S. Senate passed the Mental Health Parity Act of 2007, which like the Connecticut law would guarantee coverage comparable to what insurance customers receive for bodily injuries and ailments. The law would not apply to individual policies or to companies with fewer than 50 employees.
The Congressional Budget Office estimates the proposed law could increase the cost of insurer”™s group-plan premiums by 0.4 percent, and speculated the law could induce some employers to drop insurance coverage.
The bill is now under consideration in the U.S. House of Representatives.
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