Maine Mental Health Parity Coalition - Supporting Access to Mental Health Care

Note date and time of public hearing and LD 364 number.

Title:  Maine Mental Health Parity to Protect Access to Mental Health Care

Public Hearing for Maine LD 364 Resolve, Directing Updated Review and Evaluation of Maine's Mental Health Parity Law is scheduled for Wednesday March 2, 2011 at 9:30 AM with the Joint Standing Committee on Insurance and Financial Services room 220, Cross Building in Augusta.

Consumers of Mental Health Care are supported by the language in this resolve.

Advocates for Maine’s mentally ill, including those who care for them and consumer groups quickly developed a broad based coalition in the fall of 2010, to support a coordinated and forceful pushback to prevent attempts to repeal health care reform initiatives involving Mental Health Parity for insurance beneficiaries. 

Former Maine State Representative from Auburn Susan (Dorr) Lamb, now Executive Director of the Maine Chapter of the National Association of Social Workers (NASW) in Augusta, joined the Maine Association of Psychiatric Physicians (MAPP) to assemble a group of interested parties to strategize against any potential legislative roll back of Maine’s first in the nation Mental Health parity law. 

What is Mental Health Parity?  Parity means “equal”.  In a nutshell, mental health parity protects care covered under the beneficiary’s health insurance plans, requiring they be paid for like any other medical health care claims.  In other words, parity means no extraordinary exclusions for mental health care coverage.

Maine’s mental health parity law became a national public policy leader when State Representative Dorr led efforts to pass the law when she was in the legislature. 

In effect, the Maine Mental Health Parity law mandates offering coverage for all individual and group plans for serious mental illness for company plans, but with a 20 employee or less exemption.  It provides coverage for broad-based mental health disorders and substance abuse disorders.

Mental Health as a Medical Health Benefit:

As health care costs increase, many public and private health plans have imposed stricter cost containment techniques on the health benefits beneficiaries pay for in their insurance plans. Many plans have subjected addiction and mental health benefits, often called “behavioral health” benefits, to an even stricter form of cost containment, often in the form of higher co-pays and deductibles, shorter day and visit limits, pre-approval or “prior-authorization” for these services and other forms of “medically managing” these benefits that are more stringent than how other medical benefits are managed. (Parity Toolkit for Addiction and Mental Health Consumers, Providers and Advocates.)

Background on Parity        

Most Americans with health insurance face greater barriers in accessing services for

mental illness and addiction than they face for accessing care for other medical

conditions. The majority of health plans impose higher out of pocket spending

requirements and more restrictive treatment limitations on addiction and mental health

benefits. Today, with new medical technologies like MRIs and PET scans that allow scientists to look inside the brain, the evidence that mental illness and addiction are brain diseases is more compelling than ever before. Unfortunately, reimbursement policy has not kept up with science.  Since 1992, advocates have fought for health care equality for those with addiction and/or mental illness. A federal partial mental health parity law was passed in 1996 that was a significant step forward. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to correct discriminatory health care practices against those both with a mental illness and/or addiction. Significantly, the law aims to curb both the financial and non-financial or “non-quantitative” ways that plans limit access to addiction and mental health care. Individuals with mental illness and/or addiction, their families, professionals in the field and employers worked together to pass the law.

Does Mental Health Parity save health care dollars?  The Maine Mental Health Parity coalition is requesting in the Resolve for the Bureau of Insurance to provide an evaluation of the state’s law in light data showing how access to mental health care reduces acute care health expenses. 

Linked to this blog are two documents:  (a) Mental Health Parity Tool Kit http://www.nami.org/Template.cfm?Section=Parity1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=108469  or at http://tinyurl.com/5rhxco3

and (b) a copy of LD 364 the Resolve, Directing Updated Review and

Evaluation of Maine's Mental Health Parity Law. http://www.mainelegislature.org/legis/bills/bills_125th/billpdfs/HP029001.pdf

The Maine Mental Health Parity Coalition appreciates personal written testimony in support of the resolve to the Joint Standing Committee on Insurance and Financial Affairs Committee at the address:  http://www.maine.gov/legis/house/jt_com/ifs.htm

Insurance and Financial Services
c/o Legislative Information
100 State House Station
Augusta, ME 04333

Congressman Mike Michaud Health Care Forum in Bangor Maine

In the absence of Town Hall screamers, the health care forum hosted by Maine's Second District Congressman Mike Michaud was a thoughtful presentation from multiple health care providers about the current issue of health care reform.

Thank you Congressman Michaud for hosting this civilized and informative forum in Bangor. Too bad there weren't any big network news anchors attending to cover the issues. Following is the report of the forum by the Maine Medical Association and a copy of my own testimony on behalf of mental health parity:


Report From the Maine Medical Association Newsletter:
Congressman Michaud Hosts Forum on Health Care Reform


Congressman Mike Michaud (D-2nd District) held a forum on the national health care reform debate from 8:30 a.m. to 12:30 p.m. on Friday, August 28, 2009 at the Eastern Maine Community College in Bangor. For more than 3 1/2 hours Congressman Michaud and members of his staff listened to members of Maine's health care provider community express their views about the national health care reform debate generally and H.R. 3200, the one bill voted out of committee in the House so far, specifically. Most speakers seemed supportive of health care reform in concept, but many expressed concern that Congress not act hastily and mentioned concerns specific to a particular provider type. Physicians were well represented in the list of 25 or so witnesses and the following testified:

Gary Palman, D.O., Maine Society of Anesthesiologists
Stephanie Lash, M.D., MMA
Jon Fanburg, M.D., Maine Chapter, American Academy of Pediatrics
Julie Balaban, M.D., Maine Association of Psychiatric Physicians/Maine Association of Child & Adolescent Psychiatry
Joel Kase, D.O., Maine Osteopathic Association
Larry Piazza, M.D., Maine Society of Eye Physicians & Surgeons
Larry Mutty, M.D., M.P.H.
Charles Pattavina, M.D., St. Joseph Hospital
Congressman Michaud and his Health Legislative Assistant, Jill Brimmer, also heard testimony from representatives of hospitals, community health centers, nursing homes, pharmacists, nurses, psychologists, physical therapists, dental hygienists, ambulance companies, community mental health centers, chiropractors, and hospice providers.

Physicians who wish to communicate with Congressman Michaud's office about the national health care reform debate may reach out to Jill Brimmer at jill.brimmer@mail.house.gov


Testimony of Maine Association of Mental Health Services
Memorandum: Friday August 28, 2009

From: Juliana L’Heureux, BS, RN, MHSA
To: Congressman Mike Michaud

Ref: Testimony on Health Care Reform – Public Hearing in Bangor

Good morning. My name is Juliana L’Heureux. I am a registered nurse and the Executive Director of the Maine Association of Mental Health in Services (MAMHS) in Augusta.

MAMHS represents 27 Community Behavioral Health Centers throughout Maine.

Thank you for including mental health care to participate in this forum. Mental health providers truly appreciate your remarkable support for quality mental health care, especially for Veterans.

I also want to acknowledge the eloquent remarks from the psychiatrists who spoke before me, about the need to improve access to mental health care.

Our MAMHS members understand the complexities involved in health care reform. We are here to be a clear voice for mental health parity to be included in whatever public policy is ultimately passed. As you know, health care policy specialists worked hard for many years to achieve mental health insurance parity. Therefore, I speak for all health care providers and the clients and families we care for when we speak in support of providing mental health parity in health care reform, especially, providing for covering the cost of providing quality care. Moreover, I support the testimony from Eastern Maine Medical Center about the importance of providers being able to negotiate rates with payers. Negotiating rates is, likewise, important for community behavioral health care providers, as well.

We also seek your support for funding Community Behavioral Health Care to obtain electronic medical records.

Mental health care predisposes many physical health issues, which we know is the concept put forth in integrated care and medical home models. Certainly, we support all models of care where people are cared for out of institutions and as close to home as possible, whenever possible.

Therefore, please continue to be our advocate for protecting mental health parity in any health care reform regardless of where care is provided, including the appropriate use of tele health services.

Thank you again for your generous allocation of time to host this forum.

Juliana L'Heureux BS, RN, MHSA, Executive Director
Maine Association of Mental Health Services
45 Memorial Circle Suite 103 Augusta, Maine 04330
Telephone - (207) 621-4111 Fax - (207) 621-4999