Final Mental Health Parity Rule Released
On November 8, 2013, The U.S. Departments of Health and Human Services (HHS) in conjunction with the U.S. Department of Labor and The U.S Department of Treasury issued the final rule to implement The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). This law requires group health plans and health insurance to ensure that financial requirements such as co-pays, deductibles and treatment limitations applicable to mental health or substance use disorder benefits are equal to all medical/surgical benefits, in addition to ensuring equal treatment for residential and outpatient behavioral health care.
“This is the largest expansion of behavioral health coverage in a generation,” Kathleen Sebelius, Secretary of The U.S. Department of Health and Human Services stated as the rule was released.
APA and other mental health community partners have worked to ensure the accurate and timely implementation of the parity law. With the release of the final rule, more and more Americans will begin to see equal coverage of mental health services.
Dr. Katherine Nordal, Executive Director of The American Psychological Association Practice Organization states in a press release, “The American Psychological Association welcomes the publication of the final rule and full implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. This final rule will enhance Americans’ access to necessary mental health treatment and further protect consumers from discriminatory insurance practices.”
CMS gives notice of delayed release of the Medicare physician fee schedule
In a notice issued on October 23, 2013, the Centers for Medicare and Medicaid Services (CMS) announced that the final rule on the 2014 physician fee schedule, originally scheduled to be released in early November, has been delayed due to the recent federal government shutdown. CMS will release the final rule on or before November 27, with the new fee schedule taking effect on January 1, 2014. This year’s final rule is of great importance to psychologists since CMS is expected to announce its decision on final payment rates for the new psychotherapy codes.
In a comment letter to CMS, APAPO addresses concerns with the declining payment rates for the 2014 psychotherapy codes. APAPO will inform you when the final rule is released.
Sequestration cuts will likely remain in effect: For psychologists and all other Medicare providers, an additional 2% reduction in payments beginning in 2014 – on top of the 2% implemented in 2013.
FROM APA – Aetna Settlement of Ingenix Claims
A federal court in New Jersey has given preliminary approval to Aetna’s $120 million Ingenix settlement that we announced last December. The court has set March 28, 2014, as the deadline for eligible psychologists and other class members to submit their claims under the settlement.
As we have done with prior class action settlements, once more information on the claims process becomes available in the next few months – and well in advance of the deadline – the APA Practice Organization (APAPO) will provide guidance in the PracticeUpdate e-newsletter to help psychologists verify their eligibility and file claims. In general, psychologists are eligible to participate in the settlement if they provided out-of-network services to Aetna subscribers at some time during the period from 2003 to August 2013.