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NY AG Calls for Mental Health & Substance Use Disorder Coverage Parity


New York Attorney General Letitia James and a coalition of 18 attorneys general filed a comment letter on Wednesday urging stronger federal regulations to ensure behavioral health services are covered equally to other types of health care. The Biden Administration has proposed amendments to regulations implementing the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) that would improve compliance with the law and access to mental health and substance use disorder treatment. The comment letter filed by Attorney General James and the coalition supports these efforts and offers recommendations to ensure better healthcare coverage to millions of Americans impacted by mental health and/or substance use disorders.

In their letter, Attorney General James and the coalition of attorneys general argue that collecting this data is well within the ability of health insurers and would help identify gaps and compliance red flags. The attorneys general note that health insurers routinely collect data on metrics relevant to MHPAEA compliance as part of their normal business operations, including in- and out-of-network utilization rates, claim submission rates, claim denial rates, reimbursement rates, time and distance standards, and whether providers are accepting new patients. Despite this data collection, numerous independent, peer-reviewed studies have shown that health insurers’ networks of mental health providers are in fact so-called ‘ghost networks’ due to rampant inaccuracies in provider directories.

Additionally, the letter drafted by Attorney General James and the coalition provides recommendations for strengthening the proposed rule and urges the federal government to omit or narrow two brand-new exceptions that are overly broad and could be used by insurers to avoid providing coverage. Finally, Attorney General James and the coalition urge the relevant government agencies to quickly make the proposed rule effective, given the high level of unmet need for mental health and substance use disorder treatment and health insurers’ repeated compliance failures. The coalition concludes that by removing barriers to access, the regulations would better address America’s mental health and addiction crises.

Joining Attorney General James in filing Wednesday’s letter are the attorneys general of California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and the District of Columbia.

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