Cross-filed bills, SB586/HB1010 Health Insurance – Federal and State Mental Health and Addiction Parity Laws – Report on Compliance, are in play in the Maryland General Assembly.  The sponsors are Senator Middleton in the Finance Committee and Delegates Kelly, Cullison, Morhaim, Penna-Melnyk, Reznik, and Rosenberg in the Health and Government Operations Committee.  The bills would require health maintenance organizations, insurers, and nonprofit health service plans that offer specified contracts and health benefit plans to annually submit to the Maryland Insurance Commissioner a report certifying and outlining how these contracts and health benefit plans comply with the federal Mental Health Parity and Addiction Equity Act and state mental health and addiction parity laws.

One aspect embedded in the non-quantitative treatment limitations provisions of the legislation that has attracted the attention of the MPS and the APA is “network adequacy.”  A January 2015 study by the Mental Health Association of Maryland indicates that many psychiatrists listed on provider panels are not taking new patients, have moved, the phone number is not working, etc.  Dr. Steven Daviss has testified on behalf of the MPS and MedChi regarding the issue of network adequacy as pertains to this legislation.  The APA has also weighed in with letters from Dr. Saul Levin supporting both bills.

The federal Mental Health Parity and Addiction Equity Act prohibits group health plans from imposing separate or more restrictive financial requirements or treatment limitations on mental health and substance use disorder benefits than those imposed on other general medical benefits. Patients cannot be denied insurance reimbursement when they reach a lifetime or annual spending cap imposed on mental health or substance use disorder care.