House and Senate negotiators have resolved the remaining differences in the
benefit-related provisions in mental health care benefits parity legislation, moving the bill closer to final passage, business lobbyists say.
“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.
Filed by Jerry Geisel of Business Insurance, a sister
publication of Workforce Management. To comment, e-mail
editors@workforce.com.