“We have an accord on policy language. We’re now at the 1-yard line,” said Neil Trautwein, vice president and employee benefits counsel with the National Retail Federation in Washington.
The most significant breakthrough came last month when House negotiators agreed to drop a provision in the parity bill passed by the House last year that would have required group health care plans to cover all mental health care conditions included in the most recent edition of a diagnostic treatment manual of the American Psychiatric Association. The parity bill earlier approved by the Senate lacked such a requirement.
Negotiators now have also set the date for plans to comply with the new parity requirements at January 1 of the first calendar year after the date of enactment.
Yet to be resolved is a provision not directly related to mental health care parity. A provision in the House bill that is strongly opposed by the Bush administration would impose new restrictions on physician-owned hospitals, which the administration believes could restrict patient choice of providers.
“We are very hopeful that difference can be worked out,” Trautwein said.
If a final agreement can be reached, it still would have to be approved by the House and Senate.
At the legislation’s core is a requirement that group health care plans provide the same coverage for mental health care disorders as they do for other medical conditions.
That would be a big change from current law, which was enacted in 1996 and bars discriminatory annual and lifetime dollar limits on coverage of mental disorders. Other kinds of discrimination are permitted, though, such as health plans limiting the number of outpatient visits for treatment of mental disorders they will cover while imposing no comparable limit on other medical conditions.