Review our Fact Sheet that outlines data showing CT’s disparities ranked among the highest in the U.S.
What CT’s Parity Law Does and Does Not Do:
This legislation DOES require insurers to submit analyses demonstrating how they are in compliance with the Federal Parity Law, which has existed for over a decade, in a format that is in accordance with federal guidance issued on April 23, 2018 (see pages 13-17).
This legislation DOES NOT require insurers to report anything related to parity that is beyond what is required by the Federal Parity Law. The key terms used in this legislation are the same terms in the regulations for the Federal Parity Law.
This legislation DOES require insurers to prove to the state that they have done their due diligence to determine that they comply with the Federal law, a landmark antidiscrimination law. There is no possible way an insurer can assert that it complies with this law if it has not performed internal comparative analyses.
This legislation DOES NOT require extra administrative burden on the part of insurers, unless they are not complying with the law. If they are in fact in compliance with the law, this should be simple information to produce.
This legislation DOES eliminate barriers to lifesaving treatments for opioid use disorder. When people affected by addiction are ready to seek treatment, any administrative hurdles could directly lead to death.
Timeline of Mental Health Parity Activity:
1997: States began enacting parity laws in the 1990s, with CT’s first CT parity law put into effect in 1997 (which limited to certain biologically based conditions), and further broadened in 1999 (to cover all conditions listed in the DSM, and expanded to cover inpatient as well as Substance Use Disorders).
2008: The Mental Health Parity and Addiction Equity Act is enacted; this Federal legislation was landmark law, and built on earlier parity legislation by adding rules for cost sharing, treatment limitations, medical management protocols, scope of covered services, and more.
2017 (with an update in 2019): the Milliman report shows CT as the state with the “highest disparity between physical and behavioral healthcare in terms of the proportion of office visits that are out-of-network”; this gives advocates much needed fuel to accelerate revisions in parity compliance / law.
2018: CT Parity Coalition is formed, after years of various advocates and other groups lobbying for legislation to improve and enforce behavioral health parity in CT; the Coalition was made up of 24 organizations and individuals who worked with CT legislators, our CT Fed delegation, and experts on the national stage, primarily Patrick Kennedy and his team at the Kennedy Forum to identify the model legislation that would make a difference and receive support from legislators and the insurance industry alike.
2019: In July 2019, Governor Ned Lamont signed “An Act Concerning Mental Health and Substance Use Disorder Benefits (Public Act No. 19-159),” a law that received unanimous, bi-partisan support and requires that private insurance plans follow the regulations set forth in the 2008 federal Mental Health Parity and Addiction Equity Act (MHPAEA), and gave specific guidelines for the data required to report on (starting in 2021 and then annually) which identify gaps in plans and how plans are designed; TO DATE, WE HAVE NOT RECEIVED DECIPHERABLE REPORTS FROM THE INSURANCE INDUSTRY / INSURANCE COMMISSIONER THAT OFFERS CONFIRMATION ON COMPLIANCE WITH THE PARITY LAWS.
2019: Wit v. United Behavioral Health ruling determined that UBH violated the Federal parity laws and used guidelines that differed from generally accepted standards of care / criteria set by the American Society of Addition Medicine (ASAM), and others, resulting in denied services to treat often life-threatening emergencies; this ruling was expected to set a precedent that would finally allow for true parity to happen across health plans and states – particularly because it was found that UBH knowingly and intentionally went out of their way to design plans and deny coverage that did not comply with parity laws; UBH was ordered to reprocess all of those claims that were mishandled meaning retribution was going to take place.
March of 2022: A three-judge panel at the 9th Circuit Court of Appeals reversed the District Court’s order with a seven-page ruling, arguing that it is “not unreasonable” for insurers to determine coverage inconsistently with generally accepted standards of care. This means that the 9th Circuit found that plaintiffs in the original Wit ruling failed to demonstrate that UBH made medical necessity determinations for mental health and substance abuse that were inconsistent with generally accepted standards of care; in other words they reversed the original decision, saying that UBH did not create their own proprietary guidelines for care and, essentially, were following the law.
May – July 2022: The Kennedy Forum working closely with advocates and AGs in CT, RI, CA, and IL have all filed “amicus briefs” (which is essentially a petition to the court to reconsider its ruling) urging for this reversal to be overturned. Leading the charge in Connecticut is Attorney General William Tong, who stated: “It makes no sense, when facing the worst public health crisis in America, for insurance companies to prioritize profits over people and to stand in the way of treatment and prevention.” As of now, we are waiting to hear from the Kennedy Forum where we are in the process and if the amicus brief will be heard / considered.