Currently, Connecticut legislation requires that insurance providers follow the regulations set forth in the federal Mental Health Parity and Addiction Equity Act (MHPAEA). However, it is not always clear if these regulations are understood or activated in private health insurance plans.
The December 2017 Milliman report, “Addiction and Mental Health vs Physical Health: Analyzing Disparities in Network Use and Provider Reimbursement Rates,” identified 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. Significant disparities were also identified in inpatient care and payments to behavioral health providers compared with primary care providers.
Nationally, 20-30 states are considering or adopting new legislation to standardize compliance with the federal law. For 2019, the CT Parity Coalition is advocating that Connecticut follow suit. The 2019 bill would:
- Establish reporting requirements for insurers to demonstrate how they design and apply their managed care tactics, so regulators can determine if there is compliance with the law
- Specify how state insurance departments can implement parity and then report on their activities
- Eliminate some managed care barriers to medication-assisted treatment (MAT) for substance use disorders. While not purely parity requirements, these provisions can be a vital tool in combating the opioid epidemic
Passing this legislation is an important step towards ensuring that Connecticut’s consumer rights are protected.